增强CT与MRI在原发性肝癌患者TACE术后复查诊断的准确率研究

目的:分析增强CT与MRI在原发性肝癌TACE术后残余病灶及新发病灶复查诊断中的价值。方法:采用回顾性研究，在2017年2月至2018年5月期间纳入南阳医专二附院行TACE术治疗的84例原发性肝癌患者。所有原发性肝癌患者均接受TACE治疗，最后1次TACE完毕后的2~6个月进行数字减影血管造影（DSA）检查、MRI和CT扫描。对比增强CT扫描、MRI探查残留灶、新发灶情况；进行效能评估。结果:在复查时发现≤5 cm病灶，MRI特异度、灵敏度、准确性较增强CT高且差异有统计学意义（P<0.05）；在复查时发现有包膜病灶方面，MRI特异度、灵敏度、准确性、阳性预测值较增强CT高，其中特异度、灵敏度比较差异有统计学意义（P<0.05）；在病灶强化上，MRI特异度较增强CT高（P<0.05）。结论:与增强CT相比，MRI扫描用于原发性肝癌TACE术后残留肿瘤和新发灶检查上的价值更高，应优先使用。

Study on the accuracy of re-evaluation of CT and MRI in patients with primary liver cancer following TACE

Objective:To analyze the value of enhanced CT and MRI in the diagnosis of residual lesions and new lesions after TACE in primary hepatocellular carcinoma.Methods:A retrospective study was conducted using retrospective studies.84 cases of primary liver cancer patients who were treated with TACE during the period from February 2017 to May 2018 were included in the author's hospital.All patients with primary liver cancer received TACE treatments，and 2 to 6 months after the last TACE.Digital subtraction angiography (DSA)，MRI，and CT scans were performed.Based on the results of DSA examination，contrast-enhanced CT scans，MRI exploration of residual lesions，and new lesions were performed.Efficacy assessment was performed.Results:The MRI specificity，sensitivity，and accuracy were significantly higher than those of the enhanced CT at the time of reexamination.The difference was statistically significant (P<0.05).MRI specificity，sensitivity，accuracy and positive predictive value were in capsule lesions during reexamination higher than that of enhanced CT，and the difference in specificity and sensitivity was statistically significant (P<0.05).The specificity of MRI in focus enhancement was higher than that of enhanced CT（P<0.05）.Conclusion:Compared with enhanced CT，MRI scans are more valuable for the detection of residual tumors and new lesions after TACE in primary liver cancer and should be used preferentially.