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目的:对比分析MRI和螺旋CT增强在肝脏占位性病变诊断中的价值。方法:以2012年7月-2016年5月我院收治的临床考虑为肝脏占位性病变70例患者为研究对象,将70例患者根据入组先后顺序分为两组,35例行增强CT扫描,35例行动态增强MRI扫描,比较两组患者的病理诊断结果、病灶个数及直径、增强CT及MRI的诊断结果和检查过程中的不良反应及耐受性。结果:CT增强组和MRI增强组的肝脏占位性病变的病理诊断、病变类型、分布及病灶个数(71 vs 70)、病灶直径(2.25±2.01 cm vs2.19±1.98 cm)比较差异均无统计学意义(P>0.05);以病理诊断结果为金标准,MRI增强组的总诊断符合率为85.71%,CT增强组的总诊断符合率为77.14%,MRI增强组的总诊断符合率高于CT增强组,但差异无统计学意义(P>0.05);CT增强组共发生2例不良反应,均为轻度恶心,MRI增强组未出现造影剂不良反应,CT增强组的不良反应发生率(5.71%vs 0.00%)及视觉模拟评分法(VAS)评分(1.25 0.96分vs 0.71 0.56分)均显著高于MRI增强组(P<0.05)。结论:CT增强和MRI增强扫描对于肝脏占位性病变的诊断均具有较高的临床价值,其中MRI增强扫描的安全性和耐受性更高,临床医师可根据患者的经济状态、身体状态等因素的综合评估,选择合适的检查手段,必要时可两者联合检查,以提高诊断的准确性。
Objective: To compare the value of MRI and spiral CT in the diagnosis of liver space-occupying lesions. Methods: From July 2012 to May 2016, clinical considerations in our hospital were 70 patients with liver space-occupying lesions. The 70 patients were divided into two groups according to the order of their admission. 35 patients underwent enhanced CT Scanning and 35 dynamic contrast-enhanced MRI scans. The pathological diagnosis results, the number and diameter of lesions, the diagnostic results of CT and MRI, and the adverse reaction and tolerability during the examination were compared between the two groups. Results: Pathological diagnosis, lesions type, distribution and the number of lesions (71 vs 70) and lesion diameter (2.25 ± 2.01 cm vs 2.19 ± 1.98 cm) were significantly different between CT enhancement group and MRI enhancement group There was no statistical significance (P> 0.05). According to the result of pathological diagnosis, the overall diagnostic coincidence rate of MRI enhanced group was 85.71%, that of CT enhanced group was 77.14%, and that of MRI enhanced group was the same (P> 0.05). There were two adverse reactions in CT enhancement group, all of which were mild nausea. There was no adverse reaction of contrast agent in MRI enhancement group and adverse reaction in CT enhancement group (5.71% vs 0.00%) and visual analog scale (VAS) scores (1.25 0.96 vs 0.71 0.56) were significantly higher than those in MRI enhancement group (P <0.05). Conclusion: Both CT enhancement and MRI enhanced scan have high clinical value for the diagnosis of liver space-occupying lesions. The safety and tolerability of MRI enhanced scanning are higher. Clinicians can make the diagnosis according to their economic status, physical status, etc. Comprehensive assessment of factors, select the appropriate means of inspection, if necessary, the two can be combined to improve the diagnostic accuracy.