CAJ | 학술논문

目的：比较MRI弥散加权成像（DWI）、碘油CT和数字减影血管造影（DSA）对复发性肝癌的检出能力。方法50例肝癌切除术后确诊肝癌复发者，均行MRI DWI、DSA和碘油CT，分别由2位专家独立判读，分析三种影像学方法检出病灶总的准确度；然后依病灶直径分为3组：A组，<5 mm；B组，5 mm~30 mm；C组，>30 mm，统计对不同大小病灶的检出率。结果50例患者共检出239个病灶，其中DWI、DSA及碘油CT分别检出154，196及226个，漏诊分别为85，43及13个，准确度分别为64.4%，82.0%及94.6%，差异有统计学意义（P<0.05）。<5 mm病灶，DWI检出率50.9%（89/175），DSA检出率77.1%（135/175），碘油CT检出率96.6%（169/175），组间差异有统计学意义（P<0.05）。5 mm~30 mm病灶，DWI、DSA及碘油CT检出率分别为98.0%（51/52）、90.4%（47/52）及90.4%（47/52）（P>0.05）；>30 mm病灶，DWI、DSA及碘油CT检出率分别为100%（12/12）、83.3%（10/12）及75%（9/12）（P>0.05）。结论碘油CT诊断肝癌复发准确度最高，尤其对于微小病灶（<5 mm）检出率高；DSA次之；MRI DWI对中大病灶检出率高，微小病灶检出需与其他方法联合使用以提高敏感性。
목적：비교MRI미산가권성상（DWI）、전유CT화수자감영혈관조영（DSA）대복발성간암적검출능력。방법50례간암절제술후학진간암복발자，균행MRI DWI、DSA화전유CT，분별유2위전가독립판독，분석삼충영상학방법검출병조총적준학도；연후의병조직경분위3조：A조，<5 mm；B조，5 mm~30 mm；C조，>30 mm，통계대불동대소병조적검출솔。결과50례환자공검출239개병조，기중DWI、DSA급전유CT분별검출154，196급226개，루진분별위85，43급13개，준학도분별위64.4%，82.0%급94.6%，차이유통계학의의（P<0.05）。<5 mm병조，DWI검출솔50.9%（89/175），DSA검출솔77.1%（135/175），전유CT검출솔96.6%（169/175），조간차이유통계학의의（P<0.05）。5 mm~30 mm병조，DWI、DSA급전유CT검출솔분별위98.0%（51/52）、90.4%（47/52）급90.4%（47/52）（P>0.05）；>30 mm병조，DWI、DSA급전유CT검출솔분별위100%（12/12）、83.3%（10/12）급75%（9/12）（P>0.05）。결론전유CT진단간암복발준학도최고，우기대우미소병조（<5 mm）검출솔고；DSA차지；MRI DWI대중대병조검출솔고，미소병조검출수여기타방법연합사용이제고민감성。
ObjectiveTo compare the efficacy of MRI diffusion-weighted imaging,lipiodol-CT and digital substract angiography(DSA)in the diagnosis of recurrent hepatocellular carcinoma(HCC).MethodsA total of 50 cases of recurrent HCC after resection were performed with MRI DWI,DSA and lipiodol-CT. Two experts evaluated all data independently. The sensitivity of three imaging methods was analyzed. Recurrent lesions were divided into three groups:Group A(with diameter <5mm),Group B(5-30mm)and Group C(>30mm),then detection rate of different size of recurrent HCC was evaluated respectively.Results239 lesions were found in 50 cases.DWI,DSA and lipidol-CT detected 154,196 and 226 lesions respectively with 85,43 and 13 lost,and their sensitivity was 64.4 %,82.0% and 94.6% respectively(P<0.05).The detection rate of DWI,DSA and lipiodol-CT was 50.9%(89/175),77.1%(135/175)and 96.6%(169/175)respectively in Group A(P<0.05); 98.0%(51/52),90.4%(47/52)and 90.4%(47/52)in Group B (P>0.05); 100%(12/12),83.3%(10/12)and 75%(9/12)in Group C(P>0.05).ConclusionLipiodol CT has highest sensitivity in detection of recurrent HCC,especially for small tumor(<5 mm);The second is DSA;The detection rate of DWI is high for large lesions which needs a combination of other imaging methods to improve sensitivity for small tumor.