多层螺旋计算机断层扫描对肝细胞肝癌微血管侵犯的预测价值  

Multisliecs helieal computed tomography in predicting microvascular invasion of hepatocellular carcinoma

作　　者：刘蕾[1] 王哲[1] 赵静[1] 郭广春[1] LIU Lei;WANG Zhe;ZHAO Jing;GUO Guangchun(Department of CT Room,Nanyang Central Hospital,Nanyang 473009,He’nan,China)

机构地区：[1]南阳市中心医院CT室,河南南阳4730090

出　　处：《癌症进展》2020年第15期1581-1584,共4页Oncology Progress

摘　　要：目的探讨术前多层螺旋计算机断层扫描(MSCT)对肝细胞肝癌(HCC)微血管侵犯的预测价值。方法根据术后病理结果显示的微血管侵犯情况将120例HCC患者分为侵犯组(n=54)和未侵犯组(n=66)。所有患者均于术前进行MSCT检查,观察其检查结果与病理诊断结果一致性,比较两组患者不同影像学指标间差异,并对其预测价值进行分析。结果 MSCT诊断HCC微血管侵犯的准确度为90.83%、灵敏度为90.74%、特异度为90.91%,且MSCT诊断HCC微血管侵犯结果与病理学诊断结果具有较高的一致性(Kappa=0.82)。侵犯组患者肿瘤大小、边缘毛糙、存在晕征、门静脉期CT值、延迟期CT值均高于未侵犯组患者,肿瘤有包膜、动脉期CT值均低于未侵犯组患者,差异均有统计学意义(P<0.05)。受试者工作特征(ROC)曲线及曲线下面积(AUC)分析结果显示,肿瘤大小、边缘毛糙、有包膜、存在晕征、动脉期CT值、门静脉期CT值、延迟期CT值AUC值均明显低于上述指标联合检查AUC值,差异均有统计学意义(P<0.01)。结论 MSCT对HCC微血管侵犯预测价值较高,术前可通过患者MSCT表现判断其是否存在微血管侵犯。Objective To evaluate the value of preoperative multisliecs helieal computed tomography(MSCT) in predicting microvascular invasion of hepatocellular carcinoma(HCC).Method 120 patients with HCC were divided into invasion group(n=54) and non-invasion group(n=66) according to the microvascular invasion.All patients were examined by MSCT before operation,the consistency of examination and pathological diagnosis was observed,the differences of different imaging parameters between the two groups were compared,and the predictive value was analyzed.Result The accuracy,sensitivity and specificity of MSCT mthe diagnosis of HCC imcrovascular invasion were 90.83%,90.74%and 90.91%,respectively,and the results of MSCT diagnosis of HCC microvascular invasion were higMy consistent with those of pathological diagnosis(Kappa=0.82).The tumor size,rough margin,halo sign,portal vein phase CT and delayed phase CT values m the invasion group were significantly higher than those in the non-invasion group,while the CT values in capsule and artenal phase in the invasion group were significantly lower than those m the non-invasion group(P<0.05).The results of receiver operating characteristic(ROC) showed that area under the curve(AUC) of the tumor size,rough margin,capsule,halo sign,artenal phase CT value,portal venous phase CT value and delayed phase CT value were all significantly lower than the AUC values of combined detection(P<0.01).Conclusion MSCT is of high value in predicting imcrovascular invasion of HCC,and the presence of microvascular invasion can be judged by the MSCT findings of patients before operation.

关 键 词：肝癌 肝细胞肝癌 多层螺旋计算机断层扫描 微血管侵犯 

分 类 号：R735.7[医药卫生—肿瘤]