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多层螺旋电子计算机断层扫描与钆喷替酸葡甲胺增强磁共振成像在原发性肝癌经导管肝动脉化疗栓塞术后随访中的比较

Multi-slice spiral computed tomography versus gadolinium diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging in follow-up of primary hepatic cancer after transcatheter hepatic arterial chemoembolization

    摘要
  • 摘要:
    目的 比较多层螺旋电子计算机断层扫描(MSCT)与钆喷替酸葡甲胺(Gd-DTPA)增强磁共振成像(MRI)在原发性肝癌(PHC)经导管肝动脉化疗栓塞术(TACE)后随访中的价值。
    方法 选取PHC患者106例。以数字减影血管造影(DSA)结果为金标准，比较MSCT与Gd-DTPA增强MRI对肿瘤残余、复发的诊断准确性、敏感度、特异度。
    结果 106例患者术前有146个病灶，其中43个病灶存在肿瘤残余, MSCT诊断肿瘤残余的准确率、敏感度、特异度分别为86.30%、81.40%、88.35%, 低于Gd-DTPA增强MRI的95.89%、95.35%、96.12%, 差异有统计学意义(P < 0.05);37个病灶存在肿瘤复发, MSCT诊断肿瘤复发的准确率、敏感度、特异度分别为88.36%、80.56%、90.91%, 低于Gd-DTPA增强MRI的97.26%、97.22%、97.27%, 差异有统计学意义(P < 0.05)。
    结论 在对PHC患者TACE后肿瘤残余、复发的诊断中, Gd-DTPA增强MRI优于MSCT。

     

    Abstract:
    Objective To compare the value between multi-slice spiral computed tomography (MSCT) and gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) enhanced magnetic resonance imaging (MRI) in the follow-up of primary hepatic cancer (PHC) after transcatheter hepatic arterial chemoembolization (TACE).
    Methods A total of 106 patients with PHC were selected. The accuracy, sensitivity and specificity of MSCT and Gd-DTPA enhanced MRI in the diagnosis of tumor residue and recurrence were compared based on the results of digital subtraction angiography (DSA).
    Results There were 146 lesions in 106 patients before operation, 43 of which had residual tumors, and the accuracy, sensitivity and specificity of MSCT in diagnosing residual tumor were 86.30%, 81.40% and 88.35% respectively, which were significantly lower than 95.89%, 95.35% and 96.12% of Gd-DTPA enhanced MRI (P < 0.05); a total of 37 lesions had recurrence, and the accuracy, sensitivity and specificity of MSCT in diagnosing tumor recurrence were 88.36%, 80.56% and 90.91% respectively, which were significantly lower than 97.26%, 97.22% and 97.27% of Gd-DTPA enhanced MRI (P < 0.05).
    Conclusion Gd-DTPA enhanced MRI is superior to MSCT in the diagnosis of tumor residue and recurrence after TACE in patients with PHC.

     

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