螺旋CT灌注成像技术在鉴别肝癌及肝硬化诊断中的应用价值  

The application value spiral CT perfusion imaging in the differential diagnosis of liver cancer and liver cirrhosis

作　　者：张金彩 隋汝德 张妹 ZHANG Jincai;SUI Rude;ZHANG Mei(Department of Medical Imaging,Linyi Central Hospital,Linyi,Shandong 276400,China;Department of Medical Imaging,Tai'an Municipal Hospital,Tai'an,Shandong 271000,China)

机构地区：[1]临沂市中心医院影像科,山东临沂276400 [2]泰安市立医院医学影像科,山东泰安271000

出　　处：《影像研究与医学应用》2024年第2期12-14,共3页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨螺旋CT灌注成像技术在鉴别诊断肝癌、肝硬化中的应用价值。方法:选取2021年8月—2023年8月临沂市中心医院收治的89例肝癌、肝硬化患者,均行螺旋CT灌注成像检查,并以病理检查为金标准,统计螺旋CT灌注成像检出肝癌、肝硬化情况及诊断价值。结果:89例患者经病理检出39例肝癌,50例肝硬化;螺旋CT灌注成像检出38例肝癌,51例肝硬化,误诊1例,漏诊2例。螺旋CT灌注成像鉴别诊断的灵敏度为94.87%(37/39)、特异度为98.00%(49/50)、准确率为96.63%(86/89)、阳性预测值为97.37%(37/38)、阴性预测值为96.08%(49/51);Kappa检验显示,螺旋CT灌注成像鉴别诊断与金标准的一致性极高,Kappa值=0.931;肝癌组肝动脉灌注量(HAP)、肝血流量(BF)、肝血容积(BV)、毛细血管表面通透性(PS)高于肝硬化组,平均通过时间(MTT)短于肝硬化组,差异有统计学意义(P<0.05)。结论:螺旋CT灌注成像在肝癌、肝硬化鉴别诊断中价值高,便于早期明确具体疾病,以开展针对性治疗,更好改善患者预后。Objective To investigate the application value of spiral CT perfusion imaging in the differential diagnosis of liver cancer and cirrhosis.Methods 89 patients with liver cancer and cirrhosis admitted to Linyi Central Hospital from August 2021 to August 2023 were selected,all of whom underwent spiral CT perfusion imaging examination.Pathological examination was used as the gold standard,and the detection and diagnostic value of spiral CT perfusion imaging for liver cancer and cirrhosis were statistically analyzed.Results Among the 89 patients,39 cases of liver cancer and 50 cases of cirrhosis were detected pathologically;Among which 38 cases of liver cancer and 51 cases of cirrhosis were detected by spiral CT perfusion imaging,1 case was misdiagnosed and 2 cases were missed.The sensitivity of spiral CT perfusion imaging was 94.87%(37/39),the specificity was 98.00%(49/50),the accuracy was 96.63%(86/89),the positive predictive value was 97.37%(37/38)and the negative predictive value was 96.08%(49/51).Kappa test showed that the Kappa value of spiral CT perfusion imaging in differential diagnosis was 0.931,which was highly consistent with the gold standard.Hepatic artery perfusion volume(HAP),hepatic blood flow(BF),hepatic blood volume(BV)and capillary surface permeability(PS)in hepatocellular carcinoma group were higher than those in cirrhosis group,and the mean transit time(MTT)was shorter than that in cirrhosis group,with statistical significance(P<0.05).Conclusion Spiral CT perfusion imaging has high value in the differential diagnosis of liver cancer and cirrhosis,which facilitates early identification of specific diseases for targeted treatment and better improvement of patient prognosis.

关 键 词：肝癌 肝硬化 螺旋CT灌注成像技术 诊断价值 

分 类 号：R445.3[医药卫生—影像医学与核医学]