多排螺旋CT在肝血管瘤、肝转移瘤、原发性肝癌中的临床诊断价值分析  

Analysis of Clinical Diagnostic Value of Multi-slice Spiral CT in Hepatic Hemangioma,Hepatic Metastatic Tumor and Primary Liver Cancer

作　　者：赵晓丽 王妍妍 贾志仙 ZHAO Xiaoli;WANG Yanyan;JIA Zhixian(Department of Imaging,Anyang Hospital of Traditional Chinese Medicine,Anyang 455000,China)

机构地区：[1]安阳市中医院影像科,河南安阳455000

出　　处：《湖北民族大学学报（医学版）》2023年第2期42-45,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的分析多排螺旋CT在肝血管瘤、肝转移瘤、原发性肝癌中的临床诊断价值。方法选择2019年8月-2022年3月安阳市中医院进行诊疗的100例肝脏肿瘤患者,均给予多排螺旋CT,以病理诊断为金标准,观察多排螺旋CT对肝血管瘤、肝转移瘤、原发性肝癌鉴别诊断准确率,比较肝血管瘤、肝转移瘤、原发性肝癌三期扫描特征。结果以病理诊断为金标准,CT检查肝转移瘤:诊断准确度97.00%,灵敏度94.87%,特异度98.36%,阳性预测值97.37%,肝血管瘤:诊断准确度99.00%,灵敏度97.30%,特异度96.83%,阳性预测值94.74%,阴性预测值98.39%;原发性肝癌:诊断准确度97.00%,灵敏度91.67%,特异度97.40%,阳性预测值95.65%,阴性预测值97.4%;肝血管瘤患者第一期周边出现结节状强化,第二期病灶强化明显,第三期病灶出现向心性强化,肝转移瘤第一期边缘出现连续环状强化,第二期边缘出现连续环状强化,第三期病灶出现低密度改变,原发性肝癌第一期周边出现较为轻微的强化,第二期无明显强化,第三期病灶出现低密度改变。结论肝血管瘤、肝转移瘤、原发性肝癌患者CT三期扫描特征存在差异,多排螺旋CT检查在肝血管瘤、肝转移瘤、原发性肝癌中鉴别诊断准确率较高,可作为鉴别诊断工具,为临床诊疗提供参考。Objective To analyze the clinical diagnostic value of multi-slice spiral CT in hepatic hemangioma,liver metastasis and primary liver cancer.Methods 100 patients with liver tumors who were diagnosed and treated in our hospital from August 2019 to March 2022 were selected and were given multi-slice spiral CT and pathological examination.The accuracy of differential diagnosis of hepatic hemangioma,liver metastases and primary liver cancer by multi-row spiral CT was observed with pathological diagnosis as the gold standard.Results With pathological diagnosis as the gold standard,multi-slice spiral CT was used to detect liver metastases:diagnostic accuracy:97.00%,sensitivity:94.87%,specificity:98.36%,positive predictive value:97.37%,negative predictive value:diagnostic accuracy:99.00%,sensitivity:97.30%,specificity:96.83%,positive predictive value:94.74%,negative predictive value:98.39%;diagnostic accuracy:97.00%,sensitivity:91.67%,specificity:97.40%,positive predictive value:95.65%,negative predictive value:97.4%.Peripheral nodular enhancement was observed in patients with hepatic hemangioma in the first stage,obvious lesion enhancement in the second stage,centripetal enhancement in the third stage,continuous annular enhancement in the edge of hepatic metastases in the first stage,continuous annular enhancement in the edge of the second stage,low density change in the third stage,slight enhancement in the peripheral of primary liver cancer in the first stage,and no obvious enhancement in the second stage.It showed low density changes in the third stage.Conclusion The CT scanning characteristics of patients with liver hemangioma,liver metastasis and primary liver cancer are different in the three stages.Multi slice spiral CT has a high accuracy in differential diagnosis of liver hemangioma,liver metastasis and primary liver cancer,which can be used as a differential diagnosis tool to provide reference for clinical diagnosis and treatment.

关 键 词：肝血管瘤 肝转移瘤 原发性肝癌 多排螺旋CT 三期扫描特征 鉴别诊断 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]