The Effect Of Enhanced CT And Gd-eob-dtpa Enhanced MRI On Staging And Treatment Of Hepatocellular Carcinoma

ObjectiveTo study the difference in diagnosis of hepatocellular carcinoma(HCC)between enhanced CT and Gd-EOB-DTPA enhanced MRI,and the changes in staging and treatment of HCC caused by the difference.MethodsThe image data of enhanced CT andGd-EOB-DTPA enhanced MRI in patients with hepatocellular carcinoma diagnosed pathologically in the First Affiliated Hospital of Chongqing Medical University from March 2016 to January 2019 were analyzed.The patients were treated according to Barcelona staging criteria for hepatocellular carcinoma(2018 edition)and the criteria for diagnosis and treatment of primary hepatocellular carcinoma(2018 edition)respectively.Two-step staging of sodium-enhanced MRI image data and selection of treatment methods.Chi-square test was used to analyze the staging and treatment data of patients with hepatocellular carcinoma obtained by two imaging methods alone.P < 0.05 showed that there was statistical significance.ResultsA total of 150 patients with hepatocellular carcinoma were enrolled in this study.A total of 250 cancer nodules were found on enhanced CT.346 cancer nodules were found on Gd-EOB-DTPA enhanced MRI.The difference was statistically significant(X2 = 111.463,P = 0.000).Of the150 patients,29 were divided into BCLC 0 phase,69 into BCLC A phase,18 into BCLC B phase and 34 into BCLC C phase.Seventeen patients were divided into BCLC-0 phase,67 into BCLC-A phase,23 into BCLC-B phase and 43 into BCLC-C phase.The data were analyzed by paired chi-square test.There was significant difference between the two imaging methods in staging of hepatocellular carcinoma patients.(X2 = 13.873,P =0.003).The patients were divided into stages according to the criteria for diagnosis and treatment of primary liver cancer(2018 edition).98 patients were divided into stage I,18 patients were divided into stage II and 34 patients were divided into stage III by enhanced CT images.Eighty-four patients were divided into phase I,23 into phase II and 43 into phase III by Gd-EOB-DTPA enhanced MRI.The data were analyzed by paired chisquare test.The difference of staging between the two imaging methods was significant(X2 = 12.949,P = 0.003).There were also significant differences between the two imaging methods in the choice of treatment methods for patients with hepatocellular carcinoma.ConclusionCompared with enhanced CT,Gd-EOB-DTPA enhanced MRI may provide more accurate staging for patients with hepatocellular carcinoma,especially for patients with early stage of hepatocellular carcinoma,and there are also differences in staging for patients with advanced stage of hepatocellular carcinoma.This will help surgeons to make more accurate decisions on the treatment of patients with hepatocellular carcinoma.