肝脏 ›› 2022, Vol. 27 ›› Issue (6): 644-646.

• 肝癌 • 上一篇    下一篇

T2WI序列图像与多期多排螺旋CT扫描对肝硬化患者结节和小肝癌的鉴别诊断价值

宋文月, 耿承军, 江凯   

  1. 214000 江苏无锡 联勤保障部队第九○四医院医学影像科放射科(宋文月,耿承军);无锡市第五人民医院放射科(江凯)
  • 收稿日期:2021-11-16 出版日期:2022-06-30 发布日期:2022-08-04
  • 通讯作者: 耿承军,Email:hfgcj@yeah.net

Clinical value of T2WI sequence images and multi-slice spiral CT multi-phase scanning in differential diagnosis between nodules and small hepatocellular carcinoma in patients with liver cirrhosis

SONG Wen-yue1, GENG Cheng-jun1, JIANG Kai2   

  1. 1. Department of Radiology, Department of Medical Imaging, 904 Hospital of the Joint Logistics Support Force, Wuxi 214000, China;
    2. Department of Radiology, Wuxi Fifth People’s Hospital, Jiangsu 214000, China
  • Received:2021-11-16 Online:2022-06-30 Published:2022-08-04
  • Contact: GENG Cheng-jun, Email:hfgcj@yeah.net

摘要: 目的 探讨磁共振成像(MRI)的T2加权成像(T2WI)与多期64排螺旋电子计算机断层(64-MDCT)扫描对肝硬化患者结节和小肝癌的鉴别诊断价值。方法 选取我院2018年3月~2021年3月联勤保障部队第九○四医院收治的肝硬化背景下结节或小肝癌患者76例作为研究对象,入选对象均于术前行MRI的T2WI扫描和多期64-MDCT扫描,以术后病理组织学检查结果作为金标准,通过一致性分析评价两种检查方式单一及联合对小肝癌的诊断价值。结果 术后病理学检查结果显示,小肝癌患者46例,肝硬化结节患者30例。MRI的T2WI结果显示,小肝癌患者43例,肝硬化结节患者33例,其中肝硬化退变结节13例,肝硬化再生结节20例。多期64-MDCT检查结果显示,小肝癌患者39例,肝硬化结节患者37例。经一致性分析发现,MRI的T2WI诊断小肝癌的灵敏度、特异性分别为0.891、0.933,多期64-MDCT检查的灵敏度、特异性分别为0.804、0.933,联合诊断的灵敏度、特异性分别为0.935、0.967。结论 MRI的T2WI和多期64-MDCT扫描均可用于肝硬化患者结节、小肝癌的诊断与鉴别,且联合检查时灵敏度、特异性更高。

关键词: 磁共振成像, T2加权成像, 肝硬化, 小肝癌, 电子计算机断层扫描

Abstract: Objective To investigate the clinical value of magnetic resonance imaging (MRI) T2 weighted imaging (T2WI) and multiphase 64 slice spiral computed tomography (64-MDCT) in the differential diagnosis between nodules and small hepatocellular carcinoma (HCC) in patients with liver cirrhosis.Methods Seventy-six cirrhotic patients with nodular or small HCC admitted to our hospital from March 2018 to March 2021 were enrolled. All the subjects underwent MRI T2WI scan and multiphase 64-MDCT scan before operation. Taking the Results of postoperative histopathology as the gold standard, the diagnostic value the 2 Methods was evaluated by consistency analysis.Results The Results of postoperative pathological examination showed that there were 46 patients with small HCC and 30 patients with cirrhotic nodules.The Results of MRI T2WI showed that there were 43 patients with small HCC and 33 patients with cirrhotic nodules (including 13 cases of liver cirrhosis with degenerative nodules and 20 cases of liver cirrhosis with regenerative nodules).The Results of multiphase 64-MDCT showed that there were 39 patients with small HCC and 37 patients with cirrhotic nodules. The consistency analysis showed that the sensitivity and specificity of MRI T2WI in the diagnosis of small HCC were 0.891 and 0.933, respectively. The sensitivity and specificity of multiphase 64-MDCT were 0.804 and 0.933, respectively. The sensitivity and specificity of combined diagnosis were 0.935 and 0.967, respectively.Conclusion MRI T2WI and multiphase 64-MDCT can be used in the differential diagnosis of nodules and small HCC in patients with liver cirrhosis, and the combined examination has higher sensitivity and specificity.

Key words: Magnetic resonance imaging, T2 weighted imaging, Cirrhosis, Small hepatocellular carcinoma, Computed tomography