CT、MRI及DWI在肝细胞癌微血管浸润诊断中的应用价值

目的 探讨计算机断层扫描（CT）、磁共振成像（MRI）及磁共振弥散加权成像（DWI）在肝细胞癌微血管浸润诊断中的应用价值。方法 选取2018年1月至2021年1月我院收治的100例肝细胞癌患者作为研究对象,对患者均实施CT、MRI平扫、DWI检查。以手术病理诊断结果为金标准,比较CT、MRI平扫、DWI对肝细胞癌患者微血管浸润诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值。分析在肝细胞癌患者微血管浸润诊断中CT、MRI平扫、DWI检查与手术病理诊断结果之间的一致性;比较肝细胞癌微血管浸润与无微血管浸润患者的影像特征及表观弥散系数（ADC）。结果 以手术病理诊断结果为金标准,DWI检查对肝细胞癌患者微血管浸润的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于CT、MRI平扫（P<0.05）;CT与MRI平扫对肝细胞癌患者微血管浸润的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值比较,差异无统计学意义（P>0.05）。在肝细胞癌患者微血管浸润诊断中,CT、MRI平扫与手术病理诊断结果之间均为中度一致性,DWI与手术病理诊断结果之间为高度一致性。肝细胞癌微血管浸...

Application value of CT,MRI and DWI in the diagnosis of microvascular infiltration in hepatocellular carcinoma

Objective To investigate the application value of computed tomography(CT),magnetic resonance imaging(MRI)and diffusion weighted imaging(DWI)in the diagnosis of microvascular infiltration in hepatocellular carcinoma.Methods A total of 100 patients with hepatocellular carcinoma who were treated in our hospital from January 2018 to January 2021 were selected as the research objects,and CT,MRI and DWI examination were performed on the patients.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CT,MRI plain scan and DWI in the diagnosis of microvascular infiltration in patients with hepatocellular carcinoma were compared using the results of surgical pathological diagnosis as the gold standard.The consistency between CT,MRI plain scan,DWI and surgical pathological diagnosis results in the diagnosis of microvascular infiltration in patients with hepatocellular carcinoma were analyzed;the imaging features and apparent diffusion coefficient(ADC)between patients with and without microvascular infiltration of hepatocellular carcinoma were compared.Results Taking surgical pathological diagnosis results as the gold standard,the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of DWI for microvascular infiltration in patients with hepatocellular carcinoma were higher than those of CT and MRI plain scan(P<0.05);there were no significant differences in the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CT and MRI plain scan for microvascular infiltration in patients with hepatocellular carcinoma(P>0.05).In the diagnosis of microvascular infiltration in patients with hepatocellular carcinoma,the results of CT and MRI and the result of surgical pathological diagnosis were all moderate consistency,and the result of DWI and surgical pathological diagnosis was high consistency.The proportions of fuzzy edges,incomplete local capsule,multi nodule fusion,low-density signal ring and portal vein branch tumor thrombus in patients with microvascular infiltration of hepatocellular carcinoma were higher than those in patients without microvascular infiltration of hepatocellular carcinoma(P<0.05).Under different b values,the ADC value of hepatocellular carcinoma patients with microvascular infiltration was higher than that of hepatocellular carcinoma patients without microvascular infiltration(P<0.05).Conclusion CT,MRI,and DWI all have good diagnostic value for microvascular infiltration in patients with hepatocellular carcinoma,especially DWI,which can more sensitively and accurately determine whether microvascular infiltration occurs in patients with hepatocellular carcinoma.