16排螺旋 CT和 MRI对原发性肝癌 TACE 术后病灶的疗效判断价值对比

摘要

目的：探析16排螺旋CT和磁共振成像（ MRI）对原发性肝癌（ PHC）经导管肝动脉化疗栓塞（ TACE）术后病灶疗效的判断价值。方法2011年1月至2013年6月收治的PHC 50例患者均采用TACE治疗，术后1．5～6个月采用16排螺旋CT和MRI检查，以数字减影血管造影（ DSA）检查作为标准，对病灶的残余或复发情况及病灶肿瘤包膜的检出情况进行对比分析。结果经DSA造影检查，50例患者65个病灶中有45个病灶为肿瘤残余或复发，另外20个病灶无肿瘤残余或复发；CT组检测出30个残余或复发病灶，而MRI组检测出42个残余或复发病灶；CT判断术后病灶的准确性为76．9％（50／65），敏感性为66．7％（30／45），特异性为100．0％；MRI判断术后病灶的准确性为95．4％（62／65），敏感性为93．3％（42／45），特异性为100．0％；二者检测的准确性及敏感性差异均具有统计学意义（P均＜0．01）；CT判断术后有明显肿瘤包膜的病灶的检出率为3．1％（2／65），显著低于MRI 27．7％（18／65）的检出率，差异具有统计学意义（P＜0．01）；CT判断术后有明显肿瘤包膜的病灶的敏感性为10．0％（2／20），显著低于MRI 27．7％（18／20）的敏感性，差异具有统计学意义（P＜0．01）。结论 MRI检测可清楚显示TACE术后肿瘤残余和复发，准确评价PHC患者TACE术后疗效，优于16排螺旋CT。%Objective To discuss and analyze the assessment value of 16-slice spiral CT and MRI on clinical effects of lesions of PHC after TACE surgery .Methods 50 patients with PHC were given TACE therapy .1.5~6 months after surgery,they were given examinations of 16-slice spiral CT and MRI.DSA was adopted as standard ,residues of lesions or recurrences and le-sion tumor capsules were compared and analyzed .Results By DSA examination ,45 lesions out of 65 lesions of 50 patients were tumor residues or recurrence ,the other 20 had no tumor residues or recurrence;CT group was detected 30 lesions of residues or re-currence while MRI group was detected 42 residues or recurrence;accurate rate of CT in judging lesions after surgery was 76.9%(50/65),sensitivity was 66.7%(30/45) and specificity was 100.0%;accurate rate of MRI in judging lesions after surgery was 95.4%(62/65),sensitivity was 93.3%(42/45) and specificity was 100.0%(all P<0.01).Accurate rate of detection of le-sions with obvious tumor capsules after surgery of CT was 3.1%(2/65) obviously lower than that of MRI 27.7%(18/65) (P<0.01);sensitivity of CT in judging lesions with obvious capsules after surgery was 10.0%(2/20) obviously lower than that of MRI 90.0%(18/20) (P<0.01).Conclusion MRI can clearly manifest residues and recurrences of tumors after TACE surger-y,accurately evaluate clinical effects of PHC patients after TACE surgery ,and it is superior to 16-slice spiral CT.