论著-头颈部
3.0T MRI与64排CT 评价原发性肝癌介 入治疗后疗效的价 值
作者:郑新闻1 刘 丹2 李振平3 王常富3 董志辉3
所属单位:1.河南省三门峡市中心医院外周介 入科 (河南 三门峡 472000) 2.河南省三门峡市中心医院内镜中 心 (河南 三门峡 472000) 3.郑州大学附属洛阳中心医院CT室 (河南 洛阳 471000)
PDF摘要
目的 探讨磁共振成像(MRI)与电 子计算机断层扫描(CT)评价原发性肝癌介 入治疗后疗效的价值。方法 回顾性分析 2015年3月-2017年1月间收治的48例原发 性肝癌(PLC)患者临床资料,患者均经导 管肝动脉化疗栓塞术(TACE)治疗。患者 术后复查时均经3.0T MRI、64排CT及数 字减影血管造影(DSA)检查,以DSA为标 准,比较MRI和CT检查发现残留病灶、复 发病灶和病灶包膜的价值。结果 ①MRI检 查残留、复发病灶灵敏度、准确率均高于 CT检查(P<0.05);②MRI检出Ⅱ型碘油沉 积残留、复发病灶率高于CT(P<0.05);Ⅰ 型、Ⅲ型、Ⅳ型对比,差异无统计学意 义(P>0.05);③MRI病灶包膜检出率高于 CT(P<0.05)。结论 3.0T MRI更有利于检 出原发性肝癌经TACE后残留、复发病灶, 受碘油影响较CT小,MRI检出包膜能力也 高于CT,在评估PLC经TACE治疗后疗效价 值更高。
Objective To explore the value of magnetic resonance imaging (MRI) and computed tomography (CT) in the evaluation of efficacy after interventional therapy of primary liver cancer. Methods The clinical data of 48 patients with primary liver cancer (PLC) admitted to our hospital during March 2015 to January 2017 were analyzed retrospectively. All patients were given transcatheter arterial chemoembolization (TACE), and they were given 3.0 TMRI, 64-slice CT and digital subtraction angiography (DSA) examination postoperative review. DSA was used as the standard to compare the value of residual lesions, recurrent lesions and lesion capsule by MRI and CT. Results The sensitivity and accuracy of residual and recurrent lesions by MRI examination were higher than those by CT examination (P<0.05). The detection rates of residual and recurrent lesions of type II lipiodol deposition by MRI were higher than those by CT (P<0.05). There was no significant difference in type I, type III and type IV (P>0.05). The detection rate of capsule by MRI was higher than that by CT (P<0.05). Conclusion 3.0T MRI is more conducive to the detection of residual and recurrent lesions after TACE in PLC, and the effect of iodized oil to the lesion is smaller than that of CT. MRI also has higher ability of capsule detection rate than CT, and it has higher value in evaluating the efficacy after TACE in PLC.
【关键词】原发性肝癌;导管肝动脉化疗 栓塞术;磁共振成像;电子计 算机断层扫描
【中图分类号】R735;R730
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2019.02.010
前言
原发性肝癌(Primary carcinoma of the liver,PLC)是临床常见 恶性肿瘤之一,发病率和致死率均较高,相关流行病学资料显示,PLC 是我国恶性肿瘤致死原因第2位,每年约有38.5万人死于肝癌[1]。手术 是根治PLC的主要手段,但中晚期或肝功能较差的患者无法进行手术治 疗。非手术治疗主要包括肝动脉化疗栓塞(Transcatheter arterial hemoembolization,TACE)、消融治疗、放化疗和分子靶向治疗等, TACE被认为是PLC非手术治疗的首选标准,国内外均有研究证实,TACE 能延长PLC患者的生存期[2],且TACE具有创伤小、安全性好的特点,但 部分研究显示CT及MRI对其术后疗效评估上存在差异[3]。基于此,本研 究回顾性分析48例PLC患者临床资料,以探究MRI与CT评价原发性肝癌 介入治疗后疗效的价值,现报告如下。
中国CT和MRI杂志
第17卷, 第 2 期
2019年02月
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