CT动态增强扫描诊断原发性肝癌效能分析  

Diagnostic efficacy of CT dynamic enhancement scan in patients with liver cirrhosis and intrahepatic space-occupying lesions

作　　者：邓娜 郑玉凤 刘旭红 韩晓兵 丁碧娇 曾纬阳 刘娜红 黄莹 陈梅桂 Deng Na;Zheng Yufeng;Liu Xuhong(Department of Radiology,910th Hospital,Joint Logistic Support Force,Quanzhou 362000,Fujian Province,China)

机构地区：[1]解放军联勤保障部队第九一○医院医学影像科,福建省泉州市362000 [2]福建医科大学附属第二医院CT室,福建省泉州市362000

出　　处：《实用肝脏病杂志》2024年第6期919-922,共4页Journal of Practical Hepatology

基　　金：福建省泉州市科技发展计划项目(编号:2021C056R)。

摘　　要：目的探讨CT动态增强扫描对肝硬化合并原发性肝癌(PLC)的诊断效能。方法2018年2月~2023年5月我院诊治的120例肝硬化合并肝内结节患者,均接受CT动态增强扫描,经细针穿刺或手术后组织病理学检查结果为“金标准”,评判CT动态增强扫描诊断的效能。结果组织病理学检查诊断肝细胞癌(HCC)84例(70.0%),诊断肝内局灶性增生性结节(FPN)36例(30.0%);HCC病灶动脉期呈高增强为100.0%,门脉期呈等增强为56.0%,延迟期呈低增强为97.6%,而FPN病灶动脉期、门脉期和延迟期呈等增强者分别为88.9%、94.4%和100.0%;在120例肝硬化合并肝内结节患者中,CT动态增强扫描诊断PLC者83例(69.2%),FPN者37例(30.8%),与病理学诊断结果的Kappa值为0.902,诊断的敏感度、特异度、准确度、阴性预测值和阳性预测值分别为96.4%、94.4%、95.8%、91.9%和97.6%。结论CT动态增强扫描可以通过各期表现特点准确诊断肝硬化合并PLC病灶,具有很大的临床应用价值。Objective The aim of this study was to investigate diagnostic efficacy of CT dynamic enhancement scan in patients with liver cirrhosis and intrahepatic space-occupying lesions(SOL).Methods 120 patients with intrahepatic SOL were encountered in our hospital between February 2018 and May 2023,and all underwent CT dynamic enhancement scan.Golden diagnosis was based on histo-pathological examination by fine needle aspiration biopsies or post-operational tissues.Results Pathological diagnosis included hepatocellular carcinoma(HCC)in 84 cases(70.0%)and focal proliferative nodules(FPN)in 36 cases(30.0%)in our series;in lesions of HCC,percentage of intensified enhancement at arterial phase was 100.0%,equal enhancement at portal phase was 56.0%and low enhancement at delayed phase was 97.6%,while in lesions of FPN,the percentages of equal enhancement at arterial,portal and delayed phases were 88.9%,94.4%and 100.0%;of the 120 cirrhotics with intrahepatic SOL,CT scan diagnosed primary liver cancer in 83 cases(69.2%)and FPN in 37 cases(30.8%),with sensitivity,specificity,accuracy,negative predictive value and positive predictive value of 96.4%,94.4%,95.8%,91.9%and 97.6%,respectively(Kappa=0.902).Conclusion The feature of intrahepatic SOL showing by CT dynamic enhancement scan at different phases could help clinicians make a correct diagnosis,and deal with it appropriately.

关 键 词：原发性肝癌 肝硬化 CT动态增强扫描 诊断 

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