肝脏增强CT与肝脏MRI在肝癌中的诊断准确率比较

目的：比较肝脏增强C T与肝脏M RI对肝癌诊断的准确率，以期提高该病的诊断水平。方法回顾性分析2008年1月至2013年6月解放军421医院收治的52例原发性肝癌患者的C T和M RI影像学表现，比较两种方法对肝癌的检出情况。结果 MRI平扫 T1以低信号为主，T2以高信号为主；增强扫描动脉期明显强化CT 46例，M RI 52例，门脉期等密度C T 49例，M RI 47例，延迟期低密度或低信号C T 52例，M RI 50例。肝内病灶、肝内病灶阳性率MRI均明显优于增强CT（P＜0．05）。MRI的诊断准确率明显高于CT（P＜0．05）。对直径小于或等于3 cm的肿瘤而言，MRI的诊断准确率明显高于CT（P＜0．05），而对于直径大于3 cm的肿瘤二者之间差异无统计学意义（P＞0．05）。结论原发性肝癌的增强CT、MRI表现具有一定特征性，但肝脏MRI对肝癌的诊断准确率优于肝脏增强C T ，尤其对于直径小于或等于3 cm的肿瘤。

Comparative study of diagnostic accuracy between enhanced CT and MRI in hepatitic carcinoma

Objective To investigate the diagnostic accuracy between enhanced CT and MRI in primary hepa-titic carcinoma so as to improve diagnostic accuracy on this disease .Methods The data of enhanced CT and MRI for 52 patients with primary hepatitic carcinoma were analyzed retrospectively ,and the difference of the two methods in detecting primary hepatitic carcinoma were compared .Results The majority of tumors presented with low signal in-tensity on T1-weighted unenhanced MRI images with increased signal intensity on T 2-weighted images .Most of tumors showed intense enhancement during the arterial phase（CT in 46 cases and MRI in 52 cases） ,some appeared isointense to the liver parenchyma during portal phase（CT in 49 cases and MRI in 47 cases） .In delayed phases ,the tumors typically had lower signal intensity （CT in 52 cases and MRI in 50 cases） .The extra hepatic lesions and positve rate of extra hepatic lesions in MRI was significantly higher than that in enhanced CT （P＆lt;0 .05） .The rate of diagnostic accuracy in MRI was significantly higher than in enhanced CT （P＆lt;0 .05） .For the diameter ≤3 cm tumor , the rate of diagnostic accuracy in MRI was significantly higher than in enhanced CT （P＆lt;0 .05） ,while there was no significant difference between the two methods for the diameter ＆gt; 3 cm tumor （P＆gt; 0 .05） .Conclusion Enhanced CT ,MRI have characteristic manifestation for primary hepatitic carcinoma ,the diagnosis of primary hepatitic carcino-ma by MRI is superior to enhance CT ,especially for the diameter ≤3 cm tumor .