B超与CT对高原地区囊型肝包虫病分型中的诊断价值  

Analysis of diagnostic value of multi-slice spiral CT in the classification of cystic hepatic hydatid disease in high altitude area

作　　者：史永惠 西洛次仁 晋美旺久 向贤宏[3] SHI Yonghui;XILUO Ciren;JINMEI Wangjiu;XIANG Xianhong(Department of Radiology,Affiliated Hospital of Xizang Minzu University,Xianyang,Shaanxi 712082,China;Department of Radiology,Linzhi People′s Hospital,Linzhi,Xizang 860100,China;Department of Interventional Radiology,The First Affiliated Hospital,Sun Yat-Sen University,Guangzhou,Guangdong 510080,China)

机构地区：[1]西藏民族大学附属医院放射科,陕西咸阳712082 [2]林芝市人民医院放射科,西藏林芝860100 [3]中山大学附属第一医院放射介入科,广东广州510080

出　　处：《影像研究与医学应用》2024年第17期14-18,共5页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨多层螺旋CT、B超在囊型肝包虫病分型中的影像表现及诊断价值。方法:回顾分析林芝市人民医院2021年10月—2023年12月105例临床拟诊为肝包虫病患者的CT与B超分型结果和图像特征。通过Kappa检验评价CT、B超与病理结果的一致性,并进行受试者工作特征(ROC)曲线分析,对照两种检查方法的诊断效能。结果:105例患者术前行B超、CT共检出142个病灶,手术病理证实其中120个为囊型肝包虫病,其中单囊型(CE1型)21例,多子囊型(CE2型)15例,内囊塌陷型(CE3型)41例,实变型(CE4型)20例,钙化型(CE5型)23例。术前CT扫描检出121个囊性肝包虫病灶,21个非包虫病灶。B超检出110个肝包虫囊肿,32个非包虫病变。经Kappa检验,CT检查与病理一致性较高。B超检查与病理一致性中等。经ROC曲线分析得出,CT检查的ROC曲线下面积(AUC)为0.870(95%CI:0.803~0.920),且CT的ROC的AUC大于B超,提示CT检查诊断效能较B超高。包虫囊肿内出现子囊为肝包虫病的特征性影像表现。钙化是另一重要特征性改变,存在于囊性肝包虫病的各个类型中。结论:B超与CT是检查囊型肝包虫病的主要方法,不同类型囊型肝包虫的B超和CT表现不同,CT对囊型肝包虫诊断效能较高,在早期诊断、术前评估及疗效检测方面具有重要价值。Objective To investigate the imaging manifestations and diagnostic value of multi-slice spiral CT and B-mode ultrasonography in the classification of cystic hepatic echinococcosis.Methods CT and B-ultrasound findings and image characteristics of 105 patients with clinically proposed liver hydatid disease in Linzhi People's Hospital between October 2021 to December 2023 were retrospectively analyzed.Consistency of CT,B-ultrasound,and pathologic findings were evaluated by Kappa test,and receiver operating characteristic(ROC)curve analysis was performed,controlling for diagnostic efficacy of the two examination methods.Results A total of 142 lesions were detected by B-ultrasound and CT in 105 patients before operation,and 120 of them were proved by surgical pathology to be cystic liver hydatid disease,including 21 cases of single cystic type(CE1 type),15 cases of polycystic cystic type(CE2 type),41 cases of internal cystic collapse type(CE3 type),20 cases of consolidation type(CE4 type)and 23 cases of calcific type(CE5 type).Preoperative CT scans identified 121 cystic hepatic hydatid lesions and 21 non-hydatid lesions.110 hepatic hydatid cysts and 32 non-hydatid lesions were ultrascopically detected.With the Kappa test,there was a high agreement of CT examination with pathology.B-mode ultrasonography showed moderate agreement with pathology.From ROC curve analysis,the area under the curve(AUC)of CT was 0.870,the 95%CI was 0.803-0.920,and the area AUC of ROC curve of CT was greater than B-ultrasound,suggesting that CT examination was more diagnostic than B-ultrasound.The appearance of a child sac within a hydatid cyst was a characteristic imaging manifestation of hepatic hydatid disease.Calcification,another important characteristic alteration,was present in various types of cystic liver hydatid disease.Conclusion B-mode ultrasonography and CT are the main methods for examining cystic liver hydatid disease.Different types of cystic liver hydatid have different B-mode ultrasonography and CT manifestations,CT is more e

关 键 词：囊型肝包虫病 多排螺旋CT 诊断价值 

分 类 号：R445[医药卫生—影像医学与核医学]