基于标准切面的超声评分预测原发性肝癌可切除性  

The Resectability of Malignant Hepatic Masses Was Predicted By Ultrasound Score Based on Standard Section

作　　者：张艳芬[1] 金林原[1] 李建[1] 刘新桥 周曙[1] 蒲群旺 易彦博[2] Zhang Yanfen;Jin Linyuan;Li Jian;Liu Xinqiao;Zhou Shu;Pu Qunwang;Yi Yanbo(Department of Ultrasound,Changsha City Central Hospital,Hunan 410018,China)

机构地区：[1]长沙市中心医院超声诊断科,长沙市410018 [2]长沙市中心医院普外科,长沙市410018

出　　处：《中国超声医学杂志》2020年第7期628-631,共4页Chinese Journal of Ultrasound in Medicine

基　　金：长沙市卫生计生委科研计划课题项目资助(No.长卫发[2018]69号)。

摘　　要：目的基于肝脏标准切面的超声评分,探讨其预测原发性肝癌可切除性的临床价值。方法回顾性分析了原发性肝癌患者103例,调取其肝脏超声标准切面图像,根据米兰标准及中华外科学会肝脏学组颁布的肝癌手术适应证,明确肿块大小及数量、距第一肝门的距离、距第二肝门的距离、距下腔静脉的距离、有无腹腔淋巴结、肝实质回声改变等为超声评分指标,制定超声评分标准,根据评分标准对所有肿块进行超声评分,并验证其诊断效能。对两名医师的评分结果进行Kappa一致性检验。结果将评分≥8分者认为可以进行手术治疗,评分<8分者不能进行手术治疗,灵敏度92.3%、特异度74.0%、阳性预测值54.54%、阴性预测值96.61%、正确指数66.32%。两名医师按照超声评分标准进行评分,一致性较好(Kappa=0.799,P<0.05)。结论基于超声标准切面的原发性肝癌的超声评分,对预测原发性肝癌患者是否可以手术具有一定的临床指导意义。Objective To explore the clinical value of ultrasound score based on standard section in predicting the resectability of primary liver cancer.Methods Retrospectively analyzed 103 patients with intrahepatic mass,collected standard slice images of liver ultrasound.According to the milano standard and the indications for liver cancer surgery issued by the hepatology group of the Chinese society of surgeons,the ultrasonic scoring indexes were determined as follows:the size and number of masses,the distance from the first hilum,the distance from the second hilum,the distance from the inferior vena cava,the presence or absence of abdominal lymph nodes,and liver parenchymal echo changes.Formulate ultrasound scoring criteria,perform ultrasound scoring on all lumps according to the scoring criteria,and verify its diagnostic efficacy.The Kappa consistency test was performed on the scores of the two doctors.Results Patients with score≥8 were considered to be eligible for surgical treatment,while patients with score<8 were not eligible for surgical treatment,with sensitivity of 92.3%,specificity of 74.0%,positive predictive value of 54.54%,negative predictive value of 96.61%,and correct index of 66.32%.The two physicians were graded according to the ultrasound scoring criteria,with good consistency(Kappa=0.799,P<0.05).Conclusions The ultrasonographic score of hepatic malignant mass based on the standard section of ultrasound is of great significance for clinical diagnosis and treatment.

关 键 词：超声标准切面 原发性肝癌 超声评分 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]