【摘要】 目的：探讨常规螺旋CT、双源CT(dual-source CT,DSCT)及MRI在原发性肝癌（primary liver cancer,PLC）患者经导管肝动脉化疗栓塞（transcatheter arterial chemoembolization,TACE）术后疗效评估中的应用价值。方法：选取2020年7月至2021年6月经TACE术治疗的85例（93个病灶）PLC患者的临床资料进行回顾性分析。所有患者均采用常规螺旋CT、DSCT、MRI及数字减影血管造影（digital subtraction angiography,DSA）等方法进行病灶残留的检测，以DSA作为金标准，采用四格表法计算常规螺旋CT、DSCT及MRI检测病灶残留的阳性预测值、阴性预测值、准确率、误诊率、漏诊率；采用ROC曲线模型分析常规螺旋CT、DSCT、MRI评估PLC患者TACE术后疗效的AUC值。结果：常规螺旋CT检出病灶残留的阳性预测值为63.83%、阴性预测值为65.22%，与DSA的一致性较差（Kappa=0.290,P<0.05）;DSCT检出病灶残留的阳性预测值为82.22%、阴性预测值为81.25%，与DSA的一致性一般（Kappa=0.634,P<0.05）;MRI检出病灶残留的阳性预测值为93.48%、阴性预测值为93.62%，与DSA的一致性较好（Kappa=0.871,P<0.05）。MRI检出病灶残留的准确率高于常规螺旋CT与DSCT(P<0.05)，而误诊率、漏诊率低于常规螺旋CT(P<0.05)和DSCT(P>0.05)。ROC曲线分析显示，常规螺旋CT、DSCT、MRI评估PLC患者TACE术后疗效的AUC值分别为0.645、0.817、0.935。结论：在PLC患者TACE术后疗效评估中，MRI较常规螺旋CT、DSCT更有优势，能为临床提供可靠依据。更多还原

【Abstract】 Objective To investigate the application values of routine spiral CT, dual-source CT(DSCT) and MRI for evaluating the postoperative efficacy of primary liver cancer(PLC) patients after transcatheter arterial chemoembolization(TACE).Methods The clinical data of 85 PLC patients(93 lesions) treated by TACE from July 2020 to June 2021 were selected for retrospective analysis. All the patients were detected by routine spiral CT, DSCT, MRI and digital subtraction angiography(DSA) for lesion remnants. With DSA as the gold standard the four-fold table method was used to calculate the positive predictive values, negative predictive values, accuracies, misdiagnosis rates and missed diagnosis rates for detecting lesion remnants with routine spiral CT, DSCT and MRI, and ROC curve model was applied to analyzing the AUC values when evaluating the postoperative efficacy of PLC patients after TACE by routine spiral CT, DSCT and MRI.Results Routine spiral CT had the positive predictive value being 63.83% and the negative value being 65.22% when used to detect lesion remnants,which was in poor agreement with DSA(Kappa=0.290, P<0.05); DSCT had the positive predictive value being 82.22% and the negative value being 81.25%, which was in fair agreement with DSA(Kappa =0.634, P <0.05); MRI had the positive predictive value being 93.48% and the negative value being 93.62%, which was in high agreement with DSA(Kappa=0.871,P<0.05). MRI gained significantly higher accuracy than routine spiral CT and DSCT(P<0.05), which had statistically lower misdiagnosis and missed diagnosis rates than routine spiral CT(P <0.05) while non significantly lower misdiagnosis and missed diagnosis rates than DSCT(P>0.05). ROC curve analysis showed that the AUC values when applying routine spiral CT scan, DSCT and MRI to evaluating the postoperative efficacy of PLC patients after TACE were 0.645, 0.817 and 0.935,respectively.Conclusion MRI gains advantages over routine spiral CT and DSCT when used to evaluate the postoperative efficacy of PLC patients after TACE, which lays a solid foundation for the following clinical treatment. [Chinese Medical Equipment Journal,2022,43(9):49-53]更多还原