ABSTRACT
Objective@#To compare the application of dynamic contrast-enhanced magnetic resonance imaging (MRI) and conventional MRI in the detection of hepatocellular carcinoma (HCC) lesions before and after transcatheter arterial chemoembolization (TACE) treatment and evaluation of the effect of TACE treatment, thus to judge its application value, and to provide guidance for early clinical diagnosis.@*Methods@#Seventy-six patients with HCC who underwent TACE in Pingyang Hospital Affiliated to Wenzhou Medical University from January 2018 to December 2018 were selected in the research.According to the random number table method, 76 patients were randomly divided into control group and study group, with 38 cases in each group.The control group was examined by conventional MRI, while the study group was examined by dynamic enhancement of MRI.The lesions were observed before and after treatment, and Ktrans, Kep and ve of the two groups were recorded before and after treatment.The accuracy, sensitivity and specificity of the two groups were compared.@*Results@#Before and after treatment, the total detection rates of the study group (92.05%, 100.00%) were significantly higher than those of the control group (80.85%, 71.43%) (χ2=16.489, 15.246, all P<0.05). Before treatment, the Ktrans, Kep, ve equivalents between the two groups had no statistically significant differences (t=0.915, 0.448, 0.354, all P>0.05). After treatment, the Ktrans and Kep values of the two groups were significantly decreased, and the Ktrans[(0.419±0.101)min] and Kep[(1.073±0.237)min] values of the study group were significantly lower than those of the control group [(0.647±0.128)min, (1.158±0.221)min], the differences were statistically significant (t=9.485, 5.642, all P>0.05). There was no statistically significant difference in ve value between the two groups (t=1.025, P>0.05). The accuracy and sensitivity of detection in the study group (92.11%, 97.37%) were significantly higher than those in the control group (81.58%, 84.21%), and the specificity (94.74%) of the study group was significantly lower than that of the control group (97.37%) (χ2=17.186, 14.453, 6.489, all P<0.05).@*Conclusion@#Dynamic contrast-enhanced MRI is more effective in the detection of HCC patients before and after TACE treatment.It is convenient to provide guidance for treatment and has higher clinical application value.It is worthy of popularizing.
ABSTRACT
Objective To explore the value of cMRI and MRS in diagnosis and differential diagnosis of single brain metastases and localized high grade gliomas.Methods The cMRI (T1WI,T2WI and contrast-enhanced MRI)and MRS data of 23 cases with single brain metastases and in 28 cases with high grade gliomas confirmed by pathology were collected and analyzed retrospectively.Results cMRI:①There were no significant differences of T1WI,T2WI and constrast-enhanced MRI between single brain metastases and high-grade gliomas.②Enhanced images of single brain metastases and localized high-grade gliomas showed that there was a significant difference in the peritumoral edema area:the nodular or ring enhancement were found in single brain metastases,the outer outline of ring enhancement was smooth,and there was no enhancement at the peripheral edema area;Irregular patchy or ring enhancement were found in localized high-grade glioma tumor,both of the outer and inner edges of the ring enhancement rough,a little patchy enhancement at the peripheral edema area were found in 1 6 patients,and there was no enhancement of the edema area in the other 1 2 patients.MRS:①There were no significant differences of the tumor parenchyma in the peaks of NAA,Cr,Cho and central Lac between single brain metastases and localized high grade gliomas.②A significant difference of the peripheral edema area were observed between them.The peaks of NAA,Cr,Cho at the edema area in all single brain metastases patients were normal.But in all high-grade glioma patients,the NAA and Cr peaks were decreased,while the Cho peaks were increased.Conclusion The morphological manifestations of single brain metastases are similar to localized high grade gliomas.An obvious difference of cMRI and MRS lines exists in the peritumoral edema area between them,which could be used for differential diagnosis.