多层螺旋CT增强扫描技术在肝脏疾病诊断中的应用价值  

The application value of multi-slice spiral CT enhanced scan in the diagnosis of liver diseases

作　　者：张婧婷 ZHANG Jing-ting(Inner Mongolia Autonomous Region People's Hospital,Hohhot 010010,China)

机构地区：[1]内蒙古自治区人民医院,010010

出　　处：《中国现代药物应用》2024年第11期82-85,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探究多层螺旋CT增强扫描技术在肝脏疾病诊断中的应用价值。方法选取300例疑似肝脏疾病患者,采取多层螺旋CT增强扫描技术对其进行检查。以肝脏穿刺活检病理结果作为金标准,分析多层螺旋CT增强扫描技术的诊断效能(敏感度、特异度、阳性预测值、阴性预测值以及准确度)、一致性及影像学表现。结果300例疑似肝脏疾病患者中,金标准检查结果示216例为肝脏疾病,剩余84例为其他患者;多层螺旋CT增强扫描技术检查结果示肝脏疾病患者212例,其他患者88例。多层螺旋CT增强扫描技术诊断敏感度为95.83%(207/216)、特异度为94.05%(79/84)、准确度为95.33%(286/300)、阳性预测值为97.64%(207/212)、阴性预测值为89.77%(79/88)。多层螺旋CT增强扫描技术检查结果和肝脏穿刺活检病理结果一致较高(kappa=0.787)。216例确诊的肝脏疾病患者中,100例患者肝内存在较明显的病灶影。216例患者中20例患者肝内存在多发小强化病灶,有3例患者肝内多发小病灶在进行平扫以及超声检查后并未进行提示。在对患者进行二期扫描,即门静脉期扫描时图像显示216例患者下腔静脉、门静脉与其分支、脾静脉、肝静脉均能清晰显示,脾脏均匀强化,肝实质均匀强化。在一期扫描中强化病灶患者40例,在二期扫描中密度显著降低,表现为低密度影,其中12例患者门脉主干存在充盈缺损。在动脉期并未表现出显著变化的20例患者,在二期扫描中边缘表现为不规则强化,在进行三期扫描或延迟扫描时,该20例患者可见病灶造影剂逐步向中心进行充填,另外还有10例患者病灶在二期扫描时表现出不规则强化。在将患者图像与临床症状进行结合后发现,216例患者中,100例患者诊断为肝血管瘤,70例患者诊断为原发性肝癌,30例患者存在肝内多发转移以及门脉癌栓,还有16例患者诊断为肝脓肿。患者肝脏血液的主要供应来源为�Objective To explore the application value of multi-slice spiral CT enhanced scan in the diagnosis of liver diseases.Methods 300 patients with suspected liver disease were selected and examined by multi-slice spiral CT enhanced scan.The diagnostic efficacy(sensitivity,specificity,positive predictive value,negative predictive value and accuracy),consistency and imaging features of multi-slice spiral CT enhanced scan were analyzed using the pathological results of have liver biopsy as the gold standard.Results Among the 300 patients with suspected liver disease,216 cases were found to liver disease and the remaining 84 cases were others by the gold standard.The results of multi-slice spiral CT enhanced scan were 212 patients with liver disease and 88 patients with other diseases.The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of multi-slice spiral CT enhanced scan were 95.83%(207/216),94.05%(79/84),95.33%(286/300),97.64%(207/212)and 89.77%(79/88)respectively.The results of multi-slice spiral CT enhanced scan were highly consistent with those of liver biopsy(kappa=0.787).Among 216 patients with confirmed liver disease,100 of them had obvious lesions in the liver.Among the 216 patients,20 patients had multiple small enhanced lesions in the liver,and 3 patients had multiple small lesions in the liver that were not indicated after plain scan and ultrasound examination.In the second-phase scan,i.e.,portal vein phase,the images showed that the inferior vena cava,portal vein and its branches,splenic vein and hepatic vein could be clearly visualized in 216 patients,with homogeneous enhancement of the spleen and homogeneous enhancement of the hepatic parenchyma.The 40 patients with enhanced lesions in the first-phase scan showed a significant decrease in density in the second-phase scan,with hypodense shadows,and 12 of them had filling defects in the portal trunk.In 20 patients who did not show significant changes in the arterial phase,the margins showed irregular enha

关 键 词：肝脏疾病 螺旋CT 增强扫描技术 诊断效能 

分 类 号：R575[医药卫生—消化系统]