中晚期肝癌的超声造影与CT影像诊断及超声造影评估介入治疗疗效的价值研究  

Study on the Value of Contrast-Enhanced Ultrasound and CT Imaging in Diagnosis and Intervention Therapy of Hepatocellular Carcinoma

作　　者：张健颖 阮佳泉 何坤燕 韩江涛[1] ZHANG Jian-ying;RUAN Jia-quan;HE Kun-yan;Han Jiang-tao(Ultrasonography Department,The First People’s Hospital of Yibin,Yibin 644000,Sichuan Province,China;Ultrasonography Department,The Second People’s Hospital of Yibin,Yibin 644000,Sichuan Province,China;Ultrasonography Department,The Fifth Affiliated Hospital Sun Yat-sen University,Zhuhai 519000,Guangdong Province,China)

机构地区：[1]宜宾市第一人民医院超声科,四川宜宾644000 [2]宜宾市第二人民医院超声科,四川宜宾644000 [3]中山大学附属第五医院超声科,广东珠海519000

出　　处：《中国CT和MRI杂志》2022年第11期109-111,共3页Chinese Journal of CT and MRI

摘　　要：目的探究中晚期肝癌的超声造影与CT影像诊断及超声造影评估介入治疗疗效的价值研究。方法选取2016年10月至2020年1月医院收治的82例疑似中晚期肝癌患者,共计105个病灶。患者均进行超声造影与CT检查,并与病理诊断结果进行比较,评估两种检查方式诊断价值。在肝动脉灌注导管化疗栓塞术介入治疗1个月后进行超声造影检查,并与数字减影血管造影(DSA)进行比较。结果超声造影诊断中晚期肝癌准确率为86.67%,与病理诊断结果Kappa值为Kappa=0.644,P﹤0.001;CT诊断中晚期肝癌准确率为86.67%,与病理诊断结果Kappa值为Kappa=0.654,P﹤0.001;两种方式联合诊断中晚期肝癌准确率为90.48%,与病理诊断结果Kappa值为Kappa=0.746,P﹤0.001;两者联合评估与病理结果的一致性较好。105个病灶中的82例恶性病灶,经介入治疗后采用DSA检查存在52个病灶残留(阳性),25个病灶完全灭活(阴性),5个病灶无法准确判断;超声造影检查存在51个病灶残留(阳性),27个病灶完全灭活(阴性),4个病灶尚未确定,超声造影诊断介入治疗后阳性病灶的灵敏度98.07%(51/52)、假阴性率4%(1/25)、总符合率95.12%(78/82)。结论超声造影与CT联合诊断中晚期肝癌准确率较高,但超声造影检查操作更加简单方便,且超声造影诊断介入治疗后阳性病灶的检查灵敏度、与DSA总符合率较高,假阴性率较低,具有重要临床应用价值。Objective To explore the value of contrast-enhanced ultrasound(CEUS)and CT imaging in the diagnosis and CEUS was used to evaluate the efficacy of interventional therapy.Methods 82 patients with 105suspected small liver cancer(lesion diameter≤2.0cm liver lesions)in hospital were selected from October 2016 to January 2020.All patients underwent CEUS and CT examination.The diagnostic value of the two methods were compared with pathological results.One month after interventional therapy,CEUS examination was performed and compared with digital subtraction angiography(DSA).Results The accuracy rate of CEUS was 86.67%,and the kappa value of pathological diagnosis was kappa=0.644,P﹤0.001;the accuracy rate to CT diagnosis of hepatocellular carcinoma was 86.67%,and kappa value of pathological diagnosis was kappa=0.654,P﹤0.001;the accuracy rate of combination of two methods was(90.48%),and kappa value of pathological diagnosis was kappa=0.746,P﹤0.001 The results were in good agreement with the pathological results.Among the 105 lesions in 82 patients,82 of 105 lesions were malignant,52 lesions remained(positive),25 lesions were completely inactivated(negative),and 5 lesions could not be accurately identified;Contrast-enhanced ultrasound showed residual(positive)in 51 lesions,complete inactivation(negative)in 27 lesions,and undetermined in 4 lesions;the sensitivity of ultrasound diagnosis of positive lesions in interventional therapy was 98.07%(51/52),the false negative rate was 4%(1/25),and the total coincidence rate was 95.12%(78/82).Conclusions The accuracy of CEUS combined with CT in the diagnosis of hepatocellular carcinoma was higher,but the operation of CEUS was more simple and convenient.After interventional therapy,the sensitivity of CEUS to positive lesions and the total coincidence rate with DSA was higher,the false negative rate was lower and the CEUS had an important value of clinical applications.

关 键 词：中晚期肝癌 超声造影 CT 诊断价值 介入治疗 

分 类 号：R445.3[医药卫生—影像医学与核医学]