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目的对比分析MRI与螺旋CT(SCT)在原发性肝癌经肝动脉栓塞化疗(TACE)后随访中的应用价值。资料与方法经TACE治疗的原发性肝癌患者31例,分别于治疗前1周及治疗后3个月行MRI及SCT检查,MRI包括平扫和动态增强扫描;SCT检查包括平扫和增强后三期扫描。并于MRI与SCT检查后1周内行DSA。以DSA结果为金标准,比较MRI和SCT对于TACE后肿瘤的残留与复发显示情况。结果DSA检查发现30例39个瘤灶残留,7例新发病灶,其中2例单发,5例多发,共13个新发病灶。残留灶与新发灶均表现为局部异常肿瘤血管和肿瘤染色。MRI共显示29例36个残留灶,6例共12个新发病灶;敏感性为92%,特异性为100%。SCT显示共有23例28个残留病灶,显示6例共12个新发病灶;敏感性为72%,特异性为100%。MRI对于肿瘤残留灶的检出率、敏感性高于SCT(P<0.05),对于新发病灶两者差异无统计学意义(P>0.05)。结论与SCT比较,MRI能排除碘油沉积的影响,更加敏感地检测出肿瘤的残留、复发及新发病灶,而且更能反映肿瘤TACE治疗后的病理改变。
Objective To compare and analyze the value of MRI and spiral CT (SCT) in the follow-up of primary hepatic carcinoma after transcatheter arterial chemoembolization (TACE). Materials and Methods 31 patients with primary hepatocellular carcinoma treated with TACE underwent MRI and SCT at 1 week before treatment and 3 months after treatment respectively. MRI included plain and dynamic contrast-enhanced MRI. The SCT included plain and enhanced Three scan. DSA was performed within 1 week after MRI and SCT. DSA results as the gold standard, MRI and SCT after TACE for the comparison of the residual tumor and recurrence of the situation. Results DSA showed that there were 39 cases of tumor remaining in 30 cases and 7 cases of new lesions, of which 2 cases were single and 5 cases were multiple. There were 13 new lesions. Residual lesions and neoplasms were manifested as local abnormalities of tumor blood vessels and tumor staining. MRI showed a total of 29 cases of 36 residual lesions, 6 cases of a total of 12 new lesions; sensitivity was 92%, specificity was 100%. SCT showed a total of 23 cases of 28 residual lesions, showing a total of 6 cases of 12 new lesions; sensitivity of 72%, specificity of 100%. MRI detection rate of residual tumor was higher than that of SCT (P <0.05), but no significant difference was found between the two groups (P> 0.05). Conclusion Compared with SCT, MRI can eliminate the influence of lipiodol deposition, detect the residual tumor, recurrence and new lesions more sensitively, and can better reflect the pathological changes after TACE treatment.