MRI and CEUS Findings and Diagnostic Value of Negative AFP Hepatocellular Carcinoma
Objective To analyze the magnetic resonance imaging(MRI)and contrast-enhanced ultrasound(CEUS)manifestations and diagnostic value of alpha-fetoprotein(AFP)negative liver cancer.Methods Sixty-two patients with AFP negative liver cancer in our hospital from June 2020 to June 2022 were selected as the liver cancer group,and 44 patients with cirrhosis nodules were selected as the nodule group during the same period.MRI and CEUS were performed.Clinical data,MRI findings and CEUS findings of the two groups were compared to analyze the diagnostic value of MRI,CEUS and MRI combined with CEUS in proliferative nodules and early liver cancer.Results There were no significant differences in gender,age,body mass index,cirrhosis course,AFP,AST,ALT and focal diameter between HCC group and nodule group(P＞0.05).MRI findings:There was no difference between the two groups on T1WI,T2WI and DWI.Dynamic enhanced scanning showed that the arterial phase was significantly enhanced in the HCC group,and the contrast agent was rapidly cleared in the portal and delayed phases,while the nodular group showed different manifestations without obvious rules.ADC value in liver cancer group was lower than that in nodule group(P＜0.05).CEUS performance:Enhancement degree at different time:The enhancement intensity of CEUS in arterial phase,portal phase and delayed phase was statistically significant between HCC group and nodular group(P＜0.05).The onset time and peak time of CEUS in HCC group were shorter than those in nodule group,and the peak intensity,area under curve and curve cusp in HCC group were higher than those in nodule group(P＜0.05).Using pathological results as the gold standard,MRI and CEUS showed high consistency in the diagnosis of AFP negative liver cancer and liver cirrhosis nodules.The sensitivity of MRI combined with CEUS was 98.39％(61/62),specificity was 88.64％(39/44),and accuracy was 94.34％(100/106).Positive predictive value was 92.42％(61/66),negative predictive value was 97.50％(39/40),and Kappa value was 0.863.The diagnostic sensitivity and Kappa value of MRI combined with CEUS were higher than those of single diagnosis(P＜0.05).Conclusion MRI and CEUS have certain characteristics of AFP negative liver cancer,and the combination of the two can improve the value of differential diagnosis of AFP negative liver cancer.
Cirrhosis of the LiverMagnetic Resonance ImagingContrast-enhanced UltrasoundProliferative NodulesAlpha-fetoproteinEarly Liver CancerDiagnosis
NETL
NSTL
万方数据
维普
