磁共振成像聯合64層螺旋CT掃描診斷肝癌價值及其對介入治療指導意義

趙大全 徐建華 周愛民

[摘要] 目的 探析磁共振成像聯合64層螺旋CT掃描診斷肝癌的臨床價值及其對介入治療指導意義。方法 方便選取2018年1月—2019年8月在該院接受治療的60例肝癌患者進行分組研究，隨機分為CT組（n=30）與聯合組（n=30）。介入治療前，CT組患者給予64層螺旋CT診斷，聯合組患者給予磁共振成像聯合64層螺旋CT診斷，分析比較兩組診斷結果。兩組患者均給予介入治療，CT組采用64層螺旋CT指導，聯合組采用磁共振成像聯合64層螺旋CT指導，對比兩組治療效果。結果 CT組診斷準確率、靈敏度、特異度、陽性預測值、陰性預測值分別為80.00%、80.00%、83.33%、82.76%、80.64%，聯合組診斷數據分別為96.67%、96.67%、83.33%、85.29%、96.15%，聯合組診斷準確率、靈敏度、陰性預測值均顯著高于CT組（χ2=4.030、4.030、4.060，P<0.05），但兩組特異度、陽性預測值比較差異無統計學意義（χ2=0.000、0.850，P>0.05）。CT組殘留動脈區強化區評分、最小直徑、最大直徑分別為（4.10±0.31）分、（1.46±0.22）mm、（3.43±0.23）mm，聯合組數據分別為（4.11±0.35）分、（1.10±0.23）mm、（3.42±0.24）mm，聯合組最小直徑顯著小于CT組（χ2=5.370，P<0.05），但兩組殘留動脈區強化區評分、最大直徑比較差異無統計學意義（χ2=0.560、0.610，P>0.05）。結論 磁共振成像聯合64層螺旋CT掃描診斷肝癌的臨床價值更高，且能夠為介入治療提供可靠指導。

[關鍵詞] 肝癌;磁共振成像;64層螺旋CT;診斷價值;介入治療

[中圖分類號] R735? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2020）06（b）-0196-03

[Abstract] Objective To explore the clinical value of magnetic resonance imaging combined with 64-slice spiral CT scan in the diagnosis of liver cancer and its guiding significance for interventional therapy. Methods Sixty patients with liver cancer who were treated in the hospital from January 2018 to August 2019 were convenient selected for group study and randomly divided into CT group （n=30） and combined group （n=30）. Before interventional therapy， patients in the CT group were diagnosed with 64-slice spiral CT， and patients in the combined group were given magnetic resonance imaging combined with 64-slice spiral CT. The results of the two groups were analyzed and compared. Both groups of patients were given interventional therapy. The CT group was guided by 64-slice spiral CT， and the combined group was guided by magnetic resonance imaging combined with 64-slice spiral CT. The therapeutic effects of the two groups were compared. Results The diagnostic accuracy， sensitivity， specificity， positive predictive value and negative predictive value of CT group were 80.00%， 80.00%， 83.33%， 82.76%， 80.64%， and the diagnostic data of the combined group were 96.67%， 96.67%， 83.33%， 85.29%， 96.15%， the diagnostic accuracy， sensitivity， and negative predictive value of the combined group were significantly higher than the CT group （χ2= 4.030， 4.030， 4.060， P<0.05）， but the specificity and positive predictive values of the two groups were not statistically significant different（χ2=0.000， 0.850， P>0.05）. CT group residual arterial area enhancement area score， minimum diameter and maximum diameter were （4.10±0.31） points， （1.46±0.22） mm， （3.43±0.23） mm， the combined group data were （4.11±0.35）points， （1.10±0.23）mm，（3.42±0.24） mm， the minimum diameter of the combined group was significantly smaller than that of the CT group （χ2=5.370， P<0.05）， but there was no statistically significant difference in the score and maximum diameter of the residual arterial enhancement area between the two groups （χ2=0.560， 0.610， P>0.05）. Conclusion Magnetic resonance imaging combined with 64-slice spiral CT scan is more valuable in the diagnosis of liver cancer， and can provide reliable guidance for interventional therapy.

[Key words] Liver cancer; Magnetic resonance imaging; 64-slice spiral CT; Diagnostic value; Interventional therapy

肝癌是一種比較常見的臨床惡性腫瘤，早期臨床表現缺乏特異性，中晚期癥狀較為明顯，致使多數患者均于中晚期確診病情，錯失了最佳治療時機[1]。所以，肝癌的早期診斷及治療預后評估十分重要?，F今，磁共振成像、CT是診斷肝癌的常用方法，其中磁共振成像無法準確區分囊腫血管瘤等病變，CT無法準確區分小病灶，單獨給予磁共振成像或者CT診斷，均存在一定的局限性，因此，應加強二者聯合應用，實現優勢互補，提高診斷效果[2]?！?br>