摘要
目的探讨动态对比增强磁共振成像(DCE-MRI)检查诊断原发性肝癌(PLC)患者的效能及评价疗效的价值。方法2017年1月~2021年6月我院诊治的肝占位性病变患者68例,均接受DCE-MRI检查,并行穿刺细胞学检查诊断,应用临床流行病学基本技术评估MRI诊断的效能。所有PLC患者接受经皮肝动脉化疗栓塞术(TACE)治疗,术后再次接受MRI检查,评估疗效。结果DCE-MRI检查显示PLC患者肝内特征性恶性肿瘤表现,T1WI序列为低信号,T2WI序列为高信号,动脉期明显强化,门脉期快速消退,偶见明显的肿瘤包膜;在68例肝占位性病变患者,经穿刺细胞学检查,诊断PLC患者64例,非肿瘤病变4例;DCE-MRI检查诊断的灵敏度、特异度、准确率、阳性和阴性预测值分别为95.2%、75.0%、89.7%、93.8%和25.0%;在TACE术后,MRI检查发现肿瘤被完全灭活18例(28.1%),部分灭活25例(39.1%),肿瘤稳定15例(23.4%),疾病进展6例(9.3%)。结论DCE-MRI检查在诊断PLC和治疗后疗效判断方面有独特的作用,可指导临床制定治疗方案,价值很大。
Objective The aim of this study was to investigate the performance of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in diagnosis andevaluation of transcatheter arterial chemoembolization(TACE)efficacy in patients with primary liver cancer(PLC).Methods 68 patients with intrahepatic spaceoccupying lesions were encountered in our hospital between January 2017 and June 2021,and all patients underwent DCE-MRI and fine needle aspiration biopsies.The patients with PLC were treated by TACE.The clinical epidemiology analysis skills was applied toevaluate the performance of DCE-MRI in diagnosing PLC.Results The DCE-MRI showed that the intrahepatic malignant lesions had some special feature,such as low frequency signal in T1WI,high frequency signal in T2WI,arterial enhancement,rapid disappeared in portal stage;the cytolgical examination demonstrated the PLC in 64 cases,and non-cancerous foci in 4 cases out of our series;the sensitivity,specificity,accuracy,positive and negative predictive values by DCE-MRI diagnosis were 95.2%,75.0%,89.7%,93.8%,and 25.0%;after TACE treatment,the DCE-MRI scan showed complete remission in 18 cases(28.1%),partial remission in 25 cases(39.1%),stable disease in 15 case(23.4%)and disease progression in 6 cases(9.3%).Conclusion The DCE-MRI is a great importance in preoperative diagnosis and postoperative efficacy evaluation in patients with PLC,which could guide clinicians to make appropriate decisions for management.
作者
邬政宏
吴冬秋
刘四斌
Wu Zhenghong;Wu Dongqiu;Liu Sibin(Department of Radiology,Jingzhou Hospital Affiliated to Changjiang University,Jingzhou 434020,Hubei Province,China)
出处
《实用肝脏病杂志》
CAS
2022年第6期881-884,共4页
Journal of Practical Hepatology
基金
湖北省自然科学基金资助项目(编号:2021L0762)。
关键词
原发性肝癌
动态对比增强磁共振成像
经肝动脉化疗栓塞术
诊断效能
疗效评估
Hepatoma
Dynamic contrast-enhanced magnetic resonance imaging
Transcatheter arterial chemoembolization
Diagnostic performance
Efficacy evaluation
