螺旋CT、能谱CT和MRI诊断原发性肝癌的临床价值比较

doi:10.3969/j.issn.1672-5069.2016.04.020

摘要/Abstract

摘要： 目的探讨螺旋CT、能谱CT和MRI诊断原发性肝癌的价值比较。方法选取47例疑似原发性肝癌患者,采用螺旋CT、能谱CT和MRI诊断,比较不同扫描方法的诊断效能。结果 47例患者经三种扫描方法检查,发现能谱CT诊断的真阳性患者36例（76.59%）,常规CT为30例（63.83%）,MRI为34例（72.34%）,三种方法诊断的差异无统计学意义（P>0.05）;在8例胆管细胞癌患者中,MRI诊断7例,能谱CT和螺旋CT检查均为4例;能谱CT扫描和MRI诊断的灵敏度分别为92.3%和89.2%,均优于常规CT（76.6%,P<0.05）,能谱CT诊断的准确率为72.5%,MRI为69.7%,常规CT为50.0%（P<0.05）;此外,能谱CT扫描曲线下面积（AUC）大于常规CT或MRI（t=7.69,t=9.03,P<0.05）;在小于1 cm的肝癌中,常规CT、能谱CT和MRI扫描的灵敏度分别为53.13%,90.63%和90.63%, MRI扫描和能谱CT均高于常规CT扫描（P<0.05）。结论能谱CT扫描和MRI在诊断原发性肝癌方面,其灵敏度和准确率均优于螺旋CT扫描,在诊断小肝癌方面也具有明显的优势, MRI在诊断胆管细胞癌方面优于能谱CT或螺旋CT扫描。

关键词: 原发性肝癌, 能谱CT, 螺旋CT, MRI, 诊断

Abstract: Objective To investigate the diagnostic value of spiral CT,CT spectroscopy and MRI in diagnosis of patients with primary liver cancer. Methods Spiral CT,CT spectroscopy and MRI were carried out in 47 patients with liver-occupying foci. Results Out of the 47 patients,EDS CT set up the diagnosis in 36 patients （76.59%）,conventional CT found 30 patients （63.83%）,and MRI found 34 cases （72.34%,P>0.05）;Out of 8 patients with bile duct carcinoma,MRI found 7 patients,EDS CT and spiral CT found 4 cases,respectively;The sensitivity of spectrum CT scan and MRI were 92.3% and 89.2%,respectively,much higher than 76.6% by conventional CT （P<0.05）,and the accuracy of EDS CT was 72.5%,and that of MRI was 69.7%,much higher than 50.0% by conventional CT（P<0.05）;In less than 1 cm of liver cancer,sensitivities of conventional CT,CT and MRI scans were 53.13%,90.63% and 90.63%,（P<0.005）. Conclusion The diagnosis of primary liver cancer by EDS CT and MRI is superior to that by spiral CT,and MRI is good at finding cholangiocarcinoma.

Key words: Hepatocellular carcinoma, Spectrum CT, Spiral CT, MRI, diagnosis

王宝玲, 周连新. 螺旋CT、能谱CT和MRI诊断原发性肝癌的临床价值比较[J]. 实用肝脏病杂志, 2016, 19(4): 467-470.

Wang Baoling, Zhou Lianxin. Diagnostic value of spiral CT,CT and MRI spectroscopy in patients with primary liver cancer[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(4): 467-470.

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