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增强CT与MRI鉴别诊断肝硬化与原发性肝癌的价值

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目的 研究增强CT与MRI鉴别诊断肝硬化与原发性肝癌的价值.方法 选取2020年1月-2023年3月在抚州市东信第六医院诊治的33例肝硬化与33例原发性肝癌患者为研究对象,均进行增强CT与MRI检查,观察不同患者增强CT检查参数[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)]、MRI检查参数(峰值时间、信号增强比率、T1WI等或高信号、T2WI高信号、DWI高信号),以及不同诊断方法对肝硬化与原发性肝癌的诊断效能(敏感度、特异度、阳性预测值、阴性预测值).结果 肝硬化患者增强CT检查显示HAF、HPI、HPF均高于原发性肝癌患者(P<0.05);肝硬化患者峰值时间、信号增强比率、T1WI等或高信号占比均高于原发性肝癌患者,T2WI高信号、DWI高信号占比均小于原发性肝癌患者(P<0.05);MRI诊断肝硬化、原发性肝癌敏感度、阴性预测值均高于增强CT(P<0.05),特异度、阳性预测值与增强CT比较,差异无统计学意义(P>0.05).结论 增强CT与MRI在鉴别诊断肝硬化与原发性肝癌均具有一定的价值,并且肝硬化和原发性肝癌在增强CT与MRI检查指标方面存在差异,可为其鉴别诊断提供一定的参考.但MRI诊断肝硬化与原发性肝癌敏感度、阴性预测值较高,对于无MRI禁忌证患者可优先选择MRI鉴别诊断.
Value of Enhanced CT and MRI in Differential Diagnosis of Liver Cirrhosis and Primary Liver Cancer
Objective To study the value of enhanced CT and MRI in the differential diagnosis of liver cirrhosis and primary liver cancer.Methods From January 2020 to March 2023,33 patients with liver cirrhosis and 33 patients with primary liver cancer diagnosed and treated in Fuzhou Dongxin Sixth Hospital were selected as the research objects.All patients were examined by enhanced CT and MRI.The enhanced CT examination parameters[hepatic artery perfusion(HAF),hepatic artery perfusion index(HPI),hepatic portal vein perfusion(HPF)]and MRI examination parameters(peak time,signal enhancement ratio,T1WI equal or high signal,T2WI high signal,DWI high signal)of different patients were observed.And the diagnostic efficacy(sensitivity,specificity,positive predictive value,negative predictive value)of different diagnostic methods for cirrhosis and primary liver cancer were observed.Results Enhanced CT examination showed that HAF,HPI and HPF in patients with cirrhosis were higher than those in patients with primary liver cancer(P<0.05).The peak time,signal enhancement ratio and the proportion of equal or high signal on T1WI in patients with cirrhosis were higher than those in patients with primary liver cancer,while the proportion of high signal on T2WI and DWI were lower than those in patients with primary liver cancer(P<0.05).The sensitivity and negative predictive value of MRI in the diagnosis of liver cirrhosis and primary liver cancer were higher than those of enhanced CT(P<0.05),and compared with enhanced CT,there was no statistical significance in the specificity and positive predictive value(P>0.05).Conclusion Enhanced CT and MRI have certain value in the differential diagnosis of liver cirrhosis and primary liver cancer,and there are differences in enhanced CT and MRI examination indexes between liver cirrhosis and primary liver cancer,which can provide some reference for their differential diagnosis.However,the sensitivity and negative predictive value of MRI in the diagnosis of liver cirrhosis and primary liver cancer are high.For patients without MRI contraindications,MRI differential diagnosis can be preferred.

Enhanced CTMRIDifferential diagnosisLiver cirrhosisPrimary liver cancer

鄢岗辉、陈小华、吴鑫

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抚州市东信第六医院影像科,江西抚州 344000

抚州市第一人民医院影像科,江西抚州 344000

增强CT MRI 鉴别诊断 肝硬化 原发性肝癌

2024

医学信息
国家卫生部信息化管理领导小组 中国电子学会中国医药信息学分会 陕西文博生物信息工程研究所

医学信息

影响因子:0.161
ISSN:1006-1959
年,卷(期):2024.37(9)
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