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CT与MRI成像在肝细胞癌诊断中的价值比较及预后因素分析

Comparison of values of CT and MRI imaging in the diagnosis of hepatocellular carcinoma and analysis of prognostic factors.

作者信息

Wang Guibin, Zhu Shicai, Li Xiukui

机构信息

Department of Imaging, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China.

Department of Imaging, Linyi Thoracic Hospital, Linyi, Shandong 276002, P.R. China.

出版信息

Oncol Lett. 2019 Jan;17(1):1184-1188. doi: 10.3892/ol.2018.9690. Epub 2018 Nov 12.

Abstract

Value of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of small hepatocellular carcinoma (HCC), and in analysis of the prognostic factors of primary hepatocellular carcinoma (PHC) were compared. A total of 300 patients with PHC were selected from January 2013 to January 2016. Among them, 170 patients were diagnosed with small HCC. Patients were diagnosed by MRI and CT scans, respectively, and diagnostic efficacy of the methods was compared. A single factor and multivariate analysis of prognostic factors were performed on 300 patients. The sensitivity of MRI screening was 78.82%, specificity was 78.46%, accuracy was 78.67%, positive predictive value was 82.72%, and negative predictive value was 73.91%. CT screening showed a sensitivity of 62.35%, a specificity of 73.85%, an accuracy of 67.33%, a positive predictive value of 75.71%, and a negative predictive value of 60.00%. Differences in sensitivity, accuracy, and negative predictive value between MRI and CT screening were statistically significant (P<0.05). There was no statistically significant difference between two groups in specificity and positive predictive value (P>0.05). Diagnostic efficiency of MRI is better than that of CT diagnosis. Univariate analysis showed that age, hepatitis B cirrhosis background, tumor stage, and portal vein embolization were prognostic factors for PHC. Cox multivariate regression analysis showed that the background of liver cirrhosis, tumor stage, and portal thrombosis were independent risk factors for poor prognosis for PHC patient and the differences were statistically significant (P<0.05). MRI is superior to CT in the sensitivity, specificity and accuracy of the diagnosis of small HCC. Individualized comprehensive treatment plans based on the patient's condition may be effective in prolonging the patient's survival time. Imaging diagnosis can provide survival basis for patients, improve diagnostic accuracy, and help to improve the survival rate.

摘要

比较计算机断层扫描(CT)和磁共振成像(MRI)在小肝癌(HCC)诊断中的价值以及在原发性肝癌(PHC)预后因素分析中的价值。选取2013年1月至2016年1月期间共300例PHC患者。其中,170例患者被诊断为小肝癌。分别通过MRI和CT扫描对患者进行诊断,并比较两种方法的诊断效能。对300例患者进行预后因素的单因素和多因素分析。MRI筛查的灵敏度为78.82%,特异度为78.46%,准确度为78.67%,阳性预测值为82.72%,阴性预测值为73.91%。CT筛查的灵敏度为62.35%,特异度为73.85%,准确度为67.33%,阳性预测值为75.71%,阴性预测值为60.00%。MRI和CT筛查在灵敏度、准确度和阴性预测值方面的差异具有统计学意义(P<0.05)。两组在特异度和阳性预测值方面无统计学差异(P>0.05)。MRI的诊断效能优于CT诊断。单因素分析显示,年龄、乙肝肝硬化背景、肿瘤分期和门静脉栓塞是PHC的预后因素。Cox多因素回归分析显示,肝硬化背景、肿瘤分期和门静脉血栓形成是PHC患者预后不良的独立危险因素,差异具有统计学意义(P<0.05)。MRI在小肝癌诊断的灵敏度、特异度和准确度方面优于CT。基于患者病情制定个体化综合治疗方案可能有效延长患者生存时间。影像学诊断可为患者提供生存依据,提高诊断准确性,有助于提高生存率。

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