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目的探讨MRI弥散加权成像(DWI)与动态增强扫描(DCE)序列联合应用在肝细胞癌(HCC)患者手术切除术后检出复发微小肝癌(m HCC)的诊断价值。方法在43例肝细胞癌患者手术切除术后行MRI、DWI和DCE扫描序列,以早期发现复发癌灶。结果在术后1年,43例HCC患者中发现54个复发病灶;DWI联合DCE对复发的m HCC判断的敏感性、特异性和准确性分别为89.5%、97.1%和94.4%,DCE单独诊断的敏感性为63.2%,特异性为88.6%,准确性为79.6%,而DCE单独诊断复发m HCC的敏感性,特异性和准确性最低,分别是60.0%,67.7%和64.8%(P<0.05)。结论在MRI检查中应用DWI和DCE扫描序列联合检测能显著提高对复发的m HCC的发现率。
Objective To investigate the diagnostic value of MR diffusion weighted imaging (DWI) combined with dynamic contrast-enhanced scanning (DCE) in the detection of recurrent small hepatocellular carcinoma (HCC) after surgical resection in patients with hepatocellular carcinoma (HCC). Methods Forty-three patients with hepatocellular carcinoma underwent resection with MRI, DWI and DCE scan sequences to detect early recurrence of foci. Results One year after operation, 54 recurrent lesions were found in 43 patients with HCC. The sensitivity, specificity and accuracy of DWI combined with DCE for the diagnosis of recurrent m HCC were 89.5%, 97.1% and 94.4% Sensitivity, specificity and accuracy were 63.0%, 88.6% and 79.6%, respectively. However, the sensitivity, specificity and accuracy of DCE in the diagnosis of relapsed mHCC were the lowest (60.0%, 67.7% and 64.8%, respectively) (P < 0.05). Conclusion The combined detection of DWI and DCE in MRI can significantly improve the detection rate of recurrent m HCC.