摘要
目的分析超声、CT、MRI对肝炎后肝硬化继发肝癌患者介入治疗术后临床预后的评估价值。方法选取2014年6月至2018年6月本院收治的91例接受介入治疗的肝炎后肝硬化继发肝癌患者为研究对象,以数字减影血管造影(digital subtraction angiography,DSA)检查结果为金标准,探讨术后3～5周超声、CT及MRI对患者肿瘤活性的评估价值。结果 91例患者共检出病灶110枚,均经DSA检查结合临床随访确诊,其中DSA检出活性病灶37枚,检出率为33.64%;以DSA检查结果为金标准,超声、CT及MRI对活性病灶检出率分别为45.95%、72.97%、89.19%。超声和CT对肝炎后肝硬化继发肝癌患者介入治疗术后活性病灶的检出率均低于DSA(P_均<0.05),MRI和DSA对活性病灶检出率比较无显著差异(P> 0.05)。以DSA检查结果为金标准,超声、CT及MRI评估患者肿瘤存活的灵敏度分别为40.54%、54.05%、78.38%,特异度分别为97.18%、90.41%、94.52%,其接受者操作特征曲线下面积分别为0.906、0.824、0.515。结论 MRI能够为肝炎后肝硬化继发肝癌患者介入治疗术后肿瘤活性评估提供可靠参考,结合超声、CT能够提供更为全面的病灶信息,指导后续治疗方案的制订。
Objective To analyze the value of ultrasonography,CT and MRI in evaluating the clinical prognosis of patients with hepatocellular carcinoma secondary to post-hepatitis cirrhosis after interventional therapy,and to summarize the application experience.Method 91 patients with hepatocellular carcinoma secondary to post-hepatitis cirrhosis treated by interventional therapy in our hospital from June 2014 to June 2018 were selected as the research objects.The value of ultrasound,CT and MRI in evaluating the tumor activity of patients after 3 ~ 5 weeks of operation was analyzed based on the results of digital subtraction angiography(DSA).Result A total of 110 lesions were detected in 91 patients.All lesions were confirmed by DSA combined with clinical follow-up.37 active lesions were detected by DSA 3 ~ 5 weeks after operation,with a detection rate of 33.64%.With DSA as the gold standard,the detection rates of active lesions by ultrasonography,CT and MRI were 45.95%,72.97% and 89.19%,respectively.The detection rate of active lesions in hepatocellular carcinoma patients after interventional therapy by ultrasonography and CT was lower than that by DSA(Pall<0.05).There was no significant difference in the detection rate of active lesions between MRI and DSA(P>0.05).With DSA as the gold standard,the sensitivity,specificity of ultrasonography,CT and MRI were 40.54%,54.05%,78.38% and 97.18%,90.41%,94.52% respectively.The receiver operating characteristic(ROC)curves were 0.906,0.824 and 0.515 respectively.Conclusion MRI can provide a reliable reference for evaluating the tumor activity of patients with hepatocellular carcinoma secondary to post-hepatitis cirrhosis after interventional therapy.Combined with ultrasonography and CT,it can provide more comprehensive lesion information and guide the formulation of follow-up treatment plan.
作者
宋杰峰
张亚珍
符孔
李传资
SONG Jie-feng;ZHANG Ya-zhen;FU Kong;LI Chuan-zi(Department of Radiology,Second Affliated Hospital of Hainan Medical College,Haikou 570311,China;Department of Oncology Surgery,Second Affliated Hospital of Hainan Medical College,Haikou 570311,China)
出处
《中国医学前沿杂志（电子版）》
2019年第4期57-61,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
海南省自然科学基金(20158324)
关键词
超声
CT
MRI
肝硬化
肝癌
介入治疗
预后评估
Ultrasonography
CT
MRI
Liver cirrhosis
Liver cancer
Interventional therapy
Prognostic evaluation
