An Application Study Of Gd-EOB-DTPA MRI In The Review With Conventional Research Of TACE

Objective:Using Gd-EOB-DTPA imaging technology for primary liver cancerhepatic artery chemoembolization (transarterial chemoembolization,)with conventional postoperative cases with radiological follow-up, andwill follow-up detection intrahepatic metastasis or intrahepatic recurrenceof small hepatocellular carcinoma (small hepatocellular carcinoma,SHCC) methods of sensitivity and specificity and routine MRexamination (including: dynamic enhanced scan, scan+, scan+diffusionweighted imaging) were analyzed. To explore MRI of Gd-EOB-DTPApostoperative cases with conventional radiographic follow-up intrahepaticmetastasis or intrahepatic recurrence of small liver cancer screeningclinical significance.Methods:From June2013to March2015, the bank of China withconventional therapy, and accept the Gd-EOB-DTPA regularly atpostoperative MRI and other clinical and radiographic follow-up of12cases of primary liver cancer (hepatocellular carcinoma, HCC) in patientswith imaging data were retrospectively analyzed and were detectedduring intrahepatic recurrence or intrahepatic metastasis SHCC lesions a total of70. Study to the Gd-EOB-DTPA MRI of70lesions and itsextracts the dynamic enhanced scan, scan+, scan+Diffusion weightedimaging (coursing together-weighted imaging, DWI) can imaging dataas the research object, by two experienced high-quality imagingdiagnostic physicians, double-blind method was used to assess differentsequence image characteristics, at the same time record the observedlesion location, size, distribution and the number of signals. Each scansequence found lesions in accord with the sequence of typical HCCperformance is defined as the focus of the positive lesions (NP); Will findsuspicious for HCC and rule out other regular space-occupying lesions isdefined as the focus of the suspicious lesions (NS), and will finallyconfirmed for SHCC C (NSC) is defined as the focus of the suspiciouslesions, as of the end of the study of which are still not sure when theclinical diagnosis of the lesion is defined as a suspicious lesion U (anNSU); No abnormalities are found in the corresponding scan sequencesignal is defined as the focus of the negative lesions (NN). To calculatedifferent imaging sequences of lesion detection sensitivity and specificity.Among them will be positive lesions accounted for the total number oflesions of the sensitivity is defined as C (SC, SC=NP/70); Will bepositive and suspicious lesions C the number of the percentage of thetotal number of lesions is defined as the sum of the sensitivity of the U[(SU, SU=NP+NSC)/70]. Will the sum of the number of positive and suspicious lesions C percentage of the sum of the number of positive andsuspicious lesions is defined as a specific C=[PC, PC (NP+NSC)/(NP+NS)]; Will the number of suspicious lesions C accounts for the totalnumber of suspicious lesions of the defined as specific U (PU, PU=NSC/NS). In order to increase the diagnostic accuracy and avoiddeviation, due to the memory required to scan, scan+dynamicenhancement, scan+DWI and Gd-EOB-DTPA MRI can respectivelytwo weeks to read. Finally, using statistical analysis software SPSS17.0statistical analysis, compare different sequences detected lesionsdifferences in sensitivity and specificity, statistical methods using t testand chi-square (x2) test, set the P value is less than0.05difference isstatistically significant, P value is less than0.01significant statisticalsignificance.Result:Follow-up clinical diagnosis of intrahepatic recurrence orintrahepatic metastasis of70SHCC lesions imaging data, those two readafter reading piece in the significant enhancement scan detect lesionsnumber is64,62, the number of detected lesions in the highest of allimaging sequences (P <0.05), the sensitivity of the SC were50%,47.1%,SU is respectively91.4%,88.5%, the specificity of PU are90.6%, the PCwas95.5%,95.3%, in the <1cm and1to2cm in diameter on thedetection rate of SHCC there was no significant difference (P>0.05); Improvement of conventional dynamic phase two read the number ofdetected lesions were44, the sensitivity of the SC were44.2%,47.1%,SU is62.8%, the specificity of PU were81.2%,73.3%, PC are93.6%and93.6%respectively, the diameter of between1-2cm lesion detection has ahigh detection rate (74%85.1%), and in the lesion detection is less than1cm in diameter significantly reduce (48.8%-55.8%, P <0.05); DWIdetection corresponds to the number of dynamic enhanced scan can detectlesions similar number,42,44, the sensitivity of the SC were44.2%,41.4%, SU is respectively62.8%,60%, specificity of PU are72.2%, PCwas89.7%,89.3%; MR scan checks to detect the number of lesions isrelatively small, are30, the sensitivity of SC are38.5%, SU is42.8%,specificity of PU are60%and60%respectively, the PC were93.7%,90.9%respectively.Conclusion:Postoperative HCC with conventional radiographic follow-up MRIcan improve the Gd-EOB-DTPA intrahepatic recurrence or intrahepaticmetastasis rate of SHCC. In the preoperative diagnosis of HCC and fullycompared with conventional preoperative and postoperative radiographicdata clearly detected lesions for postoperative new hair and exclusion ofother common space-occupying lesions in the liver, Gd-EOB-DTPAMRI for intrahepatic recurrence or intrahepatic metastasis of SHCCconfirmed has reference value.