目的研究MSCT强化扫描与MRI在 评估肝癌微波消融疗效的应用。方法 选 取2014年6月至2017年6月55例肝癌(73个 病灶)患者为研究对象，所有患者均接受 微波消融治疗，并在微波消融治疗1个月 后行MSCT扫描、MRI检查及血管造影。以 血管造影结果为金标准，计算MSCT强化 扫描与MRI评估肝癌微波消融疗效的灵敏 度、特异度、阳性预测值、阴性预测值、 准确性。结果 经血管造影证实，73个肝 癌病灶，经微波消融治疗，完全消融48 个，不完全消融25个。MSCT强化扫描评估 肝癌微波消融疗效灵敏度、特异度、阳性 预测值、阴性预测值、准确性、Kappa值 分别为85.42%、68.0%、83.7%、70.8%、 79.5%、0.54。MRI检查评估肝癌微波消融 疗效的灵敏度、特异度、阳性预测值、 阴性预测值、准确性、Kappa值分别为 91.7%、92.0%、95.7%、85.2%、91.8%、 0.82。MRI检查评估肝癌微波消融疗效的 特异度、准确性显著高于MSCT强化扫描(P ＜0.05)。结论 MSCT强化扫描与MRI检查 均可清晰呈现肝癌微波消融后病灶变化。 MRI检查较MSCT强化扫描可以更准确评估 肝癌微波消融疗效。

Objective To study the application of MSCT enhanced scan and magnetic resonance imaging (MRI) in evaluating the curative effect of microwave ablation for liver cancer. Methods 55 patients with liver cancer (73 lesions) who were admitted to the hospital from June 2014 to June 2017 were selected as study subjects. All of them were treated by microwave ablation, and MSCT scan, MRI examination and angiography were performed at 1 month after microwave ablation. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MSCT enhanced scan and MRI in evaluating the curative effect of microwave ablation for liver cancer were calculated with results of angiography as the golden standard. Results Results of angiography proved that 48 of 73 liver cancer lesions reached complete response after microwave ablation and 25 reached incomplete ablation. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Kappa value of MSCT enhanced scan in evaluating the curative effect of microwave ablation for liver cancer were 85.42%, 68.0%, 83.7%, 70.8%, 79.5% and 0.54, respectively, while those of MRI were 91.7%, 92%, 95.7%, 85.2%, 91.8% and 0.82. respectively. The specificity and accuracy of MRI examination were significantly higher than those of MSCT enhanced scan (P<0.05). Conclusion MSCT enhanced scan and MRI examination can clearly show the changes of liver cancer after microwave ablation. MRI examination is more accurate than MSCT enhanced scan in evaluating the curative effect of microwave ablation for liver cancer.