目的 探讨电子计算机断层扫描 (Computed Tomography，CT)与核磁共振 (Magnetic Resonance Imaging，MRI) 在诊断原发性肝癌(primary hepatic carcinoma，PHC)介入术后病灶残留及复 发中的应用价值。方法 选取本院2015 年6月-2017年6月收治的PHC患者60例为 研究对象，共84个病灶，患者均在行经 导管肝动脉化疗栓塞术(transarterial chemoembolization，TACE)后2-6个月来 院复查，采用CT、MRI和数字减影血管造 影(Digital Subtraction Angiography, DSA)检查。以DSA为金标准，比较CT和 MRI检查对术后病灶残留、复发诊断的准 确度、敏感度、特异度，以及对病灶肿 瘤包膜的检出率。结果 CT病灶残留或复 发诊断准确度、敏感度、特异度分别为 79.76%、72.58%和100.00%，MRI病灶残留 或复发诊断准确度、敏感度、特异度分别 为94.05%、91.94%和100.00%，MRI诊断的 准确度和敏感度显著高于CT(P<0.05)；CT 肿瘤包膜检出率为3.57%，显著低于MRI 肿瘤包膜检出率10.71%(P<0.05)。结论 MRI对于PHC患者TACE术后疗效诊断准确度 高，明显优于CT诊断。

Objective To explore the application value of CT and MRI in the diagnosis of the residual and recurrent lesion of primary liver cancer after interventional therapy. Methods A total of 60 cases of PHC patients treated in our hospital from June 2015 to June 2017 were selected for the study with a total of 84 lesions, and all the patients were given review after 2-6 months of the transarterial chemoembolization (TACE). The CT, MRI and digital subtraction angiography (DSA) were performed. The accuracy, sensitivity, specificity of the diagnosis of the residues and recurrence lesion and the detection rate of the capsule were analyzed by CT and MRI examination, by taking the DSA as the gold standard. Results The accuracy, sensitivity and specificity of lesion residues and recurrence were 79.76%, 72.58% and 100.00% respectively by CT and were 94.05%, 91.94% 100.00% by MRI, and the accuracy and sensitivity of MRI diagnosis were significantly higher than those by CT (P<0.05). The detection rate of the lesion tumor capsule by CT was significantly lower than that by MRI (3.57% vs 10.71%) (P<0.05). Conclusion MRI has the high accuracy of efficacy diagnosis for PHC patients after TACE, which is significantly better than the CT diagnosis.