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目的探讨磁共振成像(MRI)对老年乙肝肝硬化背景小肝癌增强效应的诊断运用。方法选取2014年2月至2016年1月间四川省宜宾市第二人民医院收治的120例老年乙肝肝硬化患者,共138个小肝癌病灶。所有患者均行CT和MRI动态增强扫描,检测记录动脉期强化方式、病灶大小、病灶数目和包膜等情况,比较CT和MRI动脉期与延迟期病灶密度。结果 MRI与CT动脉期强化方式比较,差异无统计学意义(P>0.05)。MRI动脉期与延迟期等级评分均显著高于CT等级评分,差异均有统计学意义(均P<0.05)。CT检测假包膜显示率为40.58%,而MRI为72.46%,差异有统计学意义(P<0.05)。在诊断准确率上CT和MRI分别为93.48%和94.93%,差异无统计学意义(P>0.05)。结论 MRI相比CT法在小肝癌动脉期快速强化特征及假包膜检测敏感率上更高,MRI动态增强扫描较平扫能提高小肝癌的定性准确率。
Objective To investigate the diagnostic value of magnetic resonance imaging (MRI) in enhancing the small hepatocellular carcinoma (HCC) in the elderly with cirrhosis of the liver. Methods From January 2014 to January 2016, 120 elderly patients with hepatitis B cirrhosis who were admitted to the Second People’s Hospital of Yibin City, Sichuan Province were recruited, and 138 small hepatocellular carcinoma were selected. All patients underwent CT and MRI dynamic contrast-enhanced scanning. The patterns of arterial phase enhancement, lesion size, number of lesions and envelopment were recorded and compared. The CT and MRI arterial phase and delayed lesion density were compared. Results There was no significant difference between MRI and CT in arterial phase (P> 0.05). MRI arterial phase and delayed grade score were significantly higher than the CT grade score, the differences were statistically significant (P <0.05). The detection rate of false capsule by CT was 40.58%, while the MRI was 72.46%, the difference was statistically significant (P <0.05). The diagnostic accuracy of CT and MRI were 93.48% and 94.93%, the difference was not statistically significant (P> 0.05). Conclusion Compared with CT method, MRI is more sensitive to the rapid enhancement characteristics of arterial phase and the detection rate of pseudocapsules in small hepatocellular carcinoma. MRI dynamic contrast-enhanced scanning can improve the qualitative accuracy of small hepatocellular carcinoma.