多期增强CT扫描对原发性肝癌的诊断价值  

Consistency of multi-phase enhanced CT scanning in the diagnosis of primary liver cancer and pathological diagnosis

作　　者：韩承儒 Han Chengru(Department of Medical Imaging,First Affiliated Hospital of Henan University,Kaifen,Henan 475200,China)

机构地区：[1]河南大学第一附属医院医学影像科,河南开封475200

出　　处：《实用医技杂志》2023年第10期689-692,共4页Journal of Practical Medical Techniques

基　　金：河南省开封市科技发展计划项目(2013015)。

摘　　要：目的 分析多期增强CT扫描在原发性肝癌(PHC)诊断中与病理诊断的一致性。方法 选取河南大学第一附属医院2021年4月至2023年4月就诊的80例高度疑似PHC患者,分别给予超声检查、多期增强CT检查,以手术病理诊断作为金标准,比较超声检查、多期增强CT诊断准确率、敏感度、特异度,Kappa检验超声、多期增强CT与金标准的一致性,比较超声、多期增强CT对不同长径(<1 cm、1~5 cm、>5cm)肝癌检出率,比较良、恶性组多期增强CT动脉期、门脉期、延迟期CT增强值。结果 多期增强CT诊断准确率(92%)、敏感度(92%)、特异度(93%)均高于超声(71%、75%、66%,P<0.05),Kappa检验多期增强CT与金标准的一致性较好(Kappa值=0.791),超声与金标准的一致性一般(Kappa值=0.628)。多期增强CT对<1cm病灶检出率(95%)高于超声(47%),P<0.05,多期增强CT对1~5 cm、>5 cm病灶检出率(95%、82%)与超声(90%、91%)比较,差异无统计学意义(P>0.05)。恶性组动脉期、门脉期、延迟期CT增强值均高于良性组(P<0.05)。结论 多期增强CT可提高PHC诊断准确率、敏感度、特异度,与手术病理诊断结果接近,通过定量检测CT增强值,可辅助临床对病灶良、恶性作出鉴别诊断。Objective To analyze the consistency of multi-phase enhanced CT scanning in the diagnosis of primary liver cancer(PHC)and pathological diagnosis.Methods A total of 80 patients with high suspicion of PHC,who were treated in First Affiliated Hospital of Henan University from April 2021 to April 2023,were selected for this study.Ultrasound and multi-stage enhanced CT were respectively given.Surgical pathological diagnosis was taken as the gold standard of this study,and the diagnostic accuracy,sensitivity,and specificity of ultrasound and multi-stage enhanced CT were compared.Kappa test ultrasound and multi-stage enhanced CT were consistent with the gold standard.The detection rates of ultrasound and multi-stage enhanced CT for liver cancer with different diameters(<1 cm,1~5 cm,>5 cm)were compared,and the CT enhancement values of multi-stage enhanced CT in arterial phase,portal phase,and delayed phase were compared between the benign and malignant groups.Results The diagnostic accuracy(92%),sensitivity(92%),and specificity(93%)of multi-phase enhanced CT were higher than those of ultrasound(71%,75%,and 66%,P<0.05).Kappa test of multi-phase enhanced CT was in good agreement with the gold standard(Kappa value=0.791).Ultrasound was generally consistent with the gold standard(Kappa=0.628).The detection rate of multi-phase enhanced CT for lesions<1 cm(95%)was higher than that of ultrasound(47%),P<0.05.The detection rate of multi-phase enhanced CT for lesions 1~5 cm and>5 cm(95%,82%)was higher than that of ultrasound(90%,91%,P>0.05).The CT enhancement values of arterial stage,portal stage,and delayed stage in malignant group were higher than those in the benign group(P<0.05).Conclusion Multi-phase enhanced CT can improve the diagnostic accuracy,sensitivity,and specificity of PHC,which is close to the results of pathological diagnosis in operations.Quantitative detection of enhanced CT value can assist in the clinical diagnosis of benign and malignant lesions.

关 键 词：体层摄影术 螺旋计算机 超声检查 肝瘤 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学]