Clinical value of MRI combined with multi-slice spiral CT in evaluating the therapeutic effect of interventional therapy for primary liver cancer
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摘要:
目的 评价MRI联合多层螺旋CT(MSCT)用于原发性肝癌介入治疗患者疗效评定中的临床价值。 方法 选取2019年5月~2021年5月130例原发性肝癌介入治疗患者作为研究对象,其中50例患者接受MSCT单一检查,40例患者接受MRI单一检查,40例患者接受MRI、MSCT联合检查,所有患者均以数字减影血管造影验证。以数字减影血管造影结果为金标准,比较MRI单一检查、MSCT单一检查以及联合检查患者介入治疗后残留病灶、复发病灶的敏感度、特异性及准确性,比较3种检查方式的病灶检出率。 结果 MRI、MSCT联合检查残留病灶的敏感度为89.3%、准确性为96.2%,高于MSCT单一检查(77.9%、91.4%)和MRI单一检查(83.5%、95.9%)(P < 0.05);MRI、MSCT联合检查复发病灶的敏感度为88.6%、准确性为95.1%,高于MSCT单一检查(70.7%、91.4%)和MRI单一检查(74.2%、93.9%)(P < 0.05)。 结论 MRI联合MSCT检查用于原发性肝癌介入治疗患者疗效评定可更好的检出残留以及复发病灶,检出阳性病灶能力比单一影像学检查更高。 Abstract:Objective To evaluate the clinical value of MRI combined with multi-slice spiral CT (MSCT) in evaluating the efficacy of interventional therapy for primary liver cancer. Methods A total of 130 patients with primary liver cancer undergoing interventional therapy from May 2019 to May 2021 were selected as the study subjects, of which 50 patients received single MSCT examination, 40 patients received single MRI examination, and 40 patients received combined MRI and MSCT examination. All patients were verified by digital subtraction angiography. The sensitivity, specificity and accuracy of MRI single examination, MSCT single examination and combined examination of residual lesions and recurrent lesions after interventional therapy were compared using the results of digital subtraction angiography as the gold standard, and the lesion detection rates of three examination methods were compared. Results The sensitivity and accuracy of MRI and MSCT combined examination of residual lesions were 89.3% and 96.2%, which were higher than those of MSCT single examination (77.9%, 91.4%) and MRI alone (83.5%, 95.9%) (P < 0.05). The sensitivity and accuracy of MRI combined with MSCT were 88.6% and 95.1%, which were higher than those of MSCT single examination (70.7%, 91.4%) and MRI single examination (74.2%, 93.9%) (P < 0.05). Conclusion MRI combined with MSCT can better detect residual and recurrent lesions in patients with primary liver cancer undergoing interventional therapy, and the ability to detect positive lesions is more in line with the actual clinical needs than single imaging examination. -
表 1 MRI、MSCT单一检查及联合检查病灶检出情况
Table 1. Detection of lesions by single MRI, single MSCT and joint inspection (n)
检查方式 残留病灶 复发病灶 阴性残留病灶 阴性复发病灶 单一MSCT(n=50 81 58 27 26 单一MRI(n=40) 74 49 18 19 MRI、MSCT联合(n=40) 52 41 10 12 MSCT: 多层螺旋CT. 表 2 MSCT、MRI单一检查及联合检查诊断残留病灶的敏感度、特异性及准确性
Table 2. Sensitivity, specificity and accuracy of MRI alone, MSCT alone and joint inspection in the diagnosis of residual lesions (%)
检查方式 残留病灶 敏感度 特异性 准确性 MSCT 77.9(74/95)a 46.2(6/13) 91.4(74/81)a MRI 83.5(71/85)b 57.1(4/7) 95.9(71/74)b MRI、MSCT联合 89.3(50/56)ab 66.7(4/6) 96.2(50/52)ab aP < 0.05 vs MRI; bP < 0.05 vs MSCT. 表 3 MSCT、MRI单一检查及联合检查诊断复发病灶的敏感度、特异性及准确性
Table 3. Sensitivity, specificity and accuracy of MRI alone, MSCT alone and joint inspection in the diagnosis of residual lesions (%)
检查方式 复发病灶 敏感度 特异性 准确性 MSCT 70.7(53/75)a 44.4(4/9) 91.4(53/58)a MRI 74.2(46/62)b 50.0(3/6) 93.9(46/49)b MRI、MSCT联合 88.6(39/44)ab 77.8(7/9) 95.1(39/41ab aP < 0.05 vs MRI; bP < 0.05 vs MSCT. -
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