摘要
目的探讨增强CT与MRI对原发性肝癌与肝硬化的鉴别诊断价值。方法收集76例原发性肝癌患者及76例肝硬化患者的病历资料。比较原发性肝癌与肝硬化患者的增强CT、MRI参数;以病理结果为金标准,分析增强CT、MRI诊断结果与金标准的一致性,计算诊断效能;以受试者工作特征(ROC)曲线分析增强CT、MRI对原发性肝癌与肝硬化的鉴别诊断价值。结果原发性肝癌患者的肝动脉血流灌注量(HAF)、肝动脉灌注指数(HPI)、门静脉血流灌注量(HPF)均明显低于肝硬化患者,差异均有统计学意义(P﹤0.01)。原发性肝癌患者峰值时间、信号增强比率均明显低于肝硬化患者,差异均有统计学意义(P﹤0.01)。MRI诊断原发性肝癌的准确度为98.03%,增强CT诊断原发性肝癌的准确度为96.71%,MRI与增强CT对肝癌与肝硬化的鉴别诊断结果与金标准间均具有较高一致性(Kappa=0.961、0.934)。MRI、增强CT对原发性肝癌与肝硬化均具有较高鉴别诊断价值,MRI鉴别诊断价值高于增强CT。结论增强CT与MRI对原发性肝癌与肝硬化均具有较高诊断价值,MRI的鉴别诊断价值更高,临床应用中可根据患者具体情况选取增强CT、MRI或联合二者进行鉴别诊断,如有特殊情况只允许采取一种检查方法且无MRI禁忌证可选用MRI。
Objective To investigate the differential diagnostic value of enhanced CT and MRI in primary liver cancer and cirrhosis.Method Medical records of 76 patients with primary liver cancer and 76 patients with cirrhosis were selected.The CT and MRI parameters of patients with primary live cancer and cirrhosis were compared.The consistency of enhanced CT and MRI with the gold standard was analyzed by using pathological results as the gold standard,and the diagnostic efficacy was calculated.The value of enhanced CT and MRI in differential diagnosis of primary liver cancer and cirrhosis was analyzed by receiver operating characteristic(ROC)curve.Result The hepatic arterial flow(HAF),hepatic artery perfusion index(HPI)and hepatic portal flow(HPF)in primary liver cancer patients were lower than those in cirrhosis patients(P<0.01),the peak time and signal enhancement ratio were lower than those in cirrhosis patients(P<0.01).The accuracy of MRI for primary liver cancer was 98.03%,enhanced CT was 96.71%,and differential diagnostic results of MRI and enhanced CT had high consistency with gold standard(Kappa=0.961,0.934).MRI and enhanced CT had higher differential diagnostic value for primary liver cancer and cirrhosis,with higher value for MRI than enhanced CT.Conclusion Enhanced CT and MRI have high diagnostic value for primary liver cancer and cirrhosis,and MRI has relatively higher differential diagnostic value.In clinical application,enhanced CT,MRI or the combination of two methods can be selected according to the specific situation of patients.If only one method is appropriate under special conditions and there is no contraindication of MRI,the MRI is optional.
作者
张二宁
刘双锋
郭伟
张舒
朱鸷翔
ZHANG Erning;LIU Shuangfeng;GUO Wei;ZHANG Shu;ZHU Zhixiang(Department of Radiology,the First Affiliated Hospital of He’nan University,Kaifeng 475001,He’nan,China;Department of Magnetic Resonance,the First Affiliated Hospital of He’nan University,Kaifeng 475001,He’nan,China;Department of General Surgery,the First Affiliated Hospital of He’nan University,Kaifeng 475001,He’nan,China;Department of Pathology,the First Affiliated Hospital of He’nan University,Kaifeng 475001,He’nan,China;Department of Interventional Section,the First Affiliated Hospital of He’nan University,Kaifeng 475001,He’nan,China)
出处
《癌症进展》
2022年第12期1242-1245,共4页
Oncology Progress
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20190515)。
关键词
增强CT
MRI
原发性肝癌
肝硬化
鉴别诊断
enhanced CT
MRI
primary liver cancer
cirrhosis
differential diagnosis
