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目的比较增强多层螺旋CT(MDCT)和普美显(Gd-EOB-DTPA)增强MRI对肝癌射频消融(RFA)治疗后疗效评价的价值。方法选取于我院行RFA治疗的34例原发性肝癌患者,共42个病灶。所有患者均行增强MDCT和普美显增强MRI复查,图像由2位放射科医生进行分析,评价肿瘤有无残存或复发。结果 RFA术后1个月,42个病灶中32个病灶完全消融,10个病灶有肿瘤残存,并有6个新发病灶。增强MDCT发现34个完全消融病灶,8个肿瘤残存病灶,2个新发病灶。普美显增强MRI发现31个完全消融病灶,11个肿瘤残存病灶,6个新发病灶。普美显增强MRI图像显示RFA术后肿瘤残存的敏感性和准确性均高于增强MDCT,差异有统计学意义(均<0.05),而两者的特异性之间比较并无统计学意义(=0.606)。普美显增强MRI对RFA术后新发病灶的发现率高于增强MDCT,但差异亦无统计学意义(=0.066)。结论普美显增强MRI在肝癌RFA治疗后肿瘤残存或者复发的准确性和检出方面均优于增强MDCT。“,”Objective To compare enhanced multi-detector computerized tomography (MDCT)with MRI with Gd-EOB-DTPA in assessing tumor regression after radiofrequency ablation (RFA)after hepatocellular carcinomas (HCC).Methods 34 patients (42 HCCs)from Jau.2012 to Dec.2014 were treated with RFA and underwent enhanced MDCT and MRI with Gd-EOB-DTPA for follow up.Two radiologists reviewed these images and detection of residual or recurrent tumor were assessed.Results 32 nodules were necrotic lesions after treatment,10 showed residual diseases,and 6 new HCCs were identified.At 1 month after RFA enhanced CT has identified 34 necrotic lesions,8 residual diseases and 2 new HCCs.At MRI with Gd-EOB-DTPA instead,31 complete necrotic lesions,11 residual diseases and 6 new HCCS were identified.The sensitivity and accuracy of MRI with Gd-EOB-DTPA in detecting residual diseases were significantly higher than those of enhanced MDCT (All P<0.05)but the difference in the specificity between them was not statistical ( =0.606).The rate of detecting new HCCs of MRI with Gd-EOB-DTPA were higher than that of enhanced MDCT,but the difference was not statistical ( =0.066).Conclusion MRI with Gd-EOB-DTPA is superior to enhanced MDCT in diagnostic accuracy and detection rate of residual diseases or recurrent tumor after RFA.