64排螺旋CT在脂肪肝合并肝脏结节性疾病中的诊断价值  

Diagnostic value of 64-slice spiral CT on fatty liver combining with nodular diseases of the liver

作　　者：张志强[1] 李孟云[1] 

机构地区：[1]广东省梅州市人民医院CT科,广东梅州514000

出　　处：《中国当代医药》2015年第18期59-61,共3页China Modern Medicine

摘　　要：目的 探讨64排螺旋CT在脂肪肝合并肝脏结节性疾病诊断中的价值。方法 选取2013年1月-2014年8月因脂肪肝合并肝脏结节性疾病在本院就诊的78例患者为研究对象。所有病例均行常规超声和64排螺旋CT检查,由2名高年资影像科医生阅片,与外科手术或者超声引导下的经皮肝脏穿刺组织活检病理结果进行对照分析。比较常规超声和64排螺旋CT检查敏感度、特异度、阳性预测值、阴性预测值和准确度。结果 病理结果显示,78例患者,共86个病灶。其中良性病变患者27例,占34.62%,共32个病灶,占37.21%;恶性病变患者51例,占65.38%,共54个病灶,占62.79%。常规超声检查对脂肪肝合并肝脏结节性疾病恶性病变的灵敏度、特异度、阳性预测值、阴性预测值、诊断准确度分别为76.5%、59.3%、78.0%、57.1%、70.5%,64排螺旋CT分别为92.2%、92.6%、95.9%、86.2%、92.3%,64排螺旋CT显著高于常规超声检查（P〈0.05或P〈0.01）。结论 应用64排螺旋CT对脂肪肝合并肝脏结节性疾病诊断具有较高的灵敏度、特异度和准确度,值得临床推广应用。Objective To evaluate the diagnostic value of 64-slice spiral computed tomography（CT） on fatty liver combining with nodular diseases of the liver. Methods From January 2013 to August 2014,78 patients suffered from fatty liver with nodular diseases of the liver who were visited our hospital for treatment were selected as research objects.All patients were performed with conventional ultrasound and 64-slice spiral CT examination.The images were read by two senior radiological doctors,which were compared and analyzed by pathological outcomes by percutaneous liver puncture biopsy guided by surgery or ultrasound.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of conventional ultrasound and 64-slice spiral CT were compared. Results Among 78 patients,there were 86 foci,of which 27 cases were in benign accounting for 34.62%（32 foci for 37.21%） and the rest 51 cases belonged to malignant lesions accounting for 65.38%（54 foci for 62.79%）.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of conventional ultrasound on fatty liver combining with nodular diseases of the liver was 76.5%,59.3%,78.0%,57.1%,70.5%,respectively,and the rates by 64-slice spiral CT was 92.2%,92.6%,95.9%,86.2%,and 92.3% accordingly.The indexes examined by 64-slice spiral CT were much higher than those by conventional ultrasound（P〈0.05 or P〈0.01）. Conclusion Application of 64-slice spiral CT obtains a higher sensitivity,specificity,and accuracy on treating fatty liver combining with nodular diseases of the liver,which is worthy of expansion in clinic.

关 键 词：肝脏结节性疾病 脂肪肝 64排螺旋CT 诊断 

分 类 号：R814.42[医药卫生—影像医学与核医学]