CT增强扫描在良恶性胆囊息肉样病变鉴别诊断中的价值  

The value of enhanced CT scanning in differential diagnosis of benign and malignant polypoid lesions of gallbladder

作　　者：龚亨 计一丁 丁宁[1] 刘利[1] 张亦弛 尹胜男[1] GONG Heng;JI Yiding;DING Ning;LIU Li;ZHANG Yichi;YIN Shengnan(Department of Medical Imaging,The Ninth People’s Hospital of Soochow University,Soochow 215200,China)

机构地区：[1]苏州大学附属苏州九院影像科,江苏苏州215200

出　　处：《医学影像学杂志》2024年第12期99-102,共4页Journal of Medical Imaging

基　　金：江苏省医学会伦琴影像科研专项资金项目[编号:SYH-3201150-0018(2021013)];江苏省苏州市“科教兴卫”青年科技项目(编号:KJXW2022077)。

摘　　要：目的探讨CT增强扫描在良恶性胆囊息肉样病变中的鉴别诊断价值。方法选取我院97例行胆囊切除术的胆囊息肉样病变患者,根据术后病理结果分为两组,良性组65例,恶性组32例。患者术前2周内行CT平扫和三期增强扫描,临床及影像学资料由2位资深放射科医师分析。结果两组中女性的数量均大于男性,组间比较差异无统计学意义(P=0.78),良性组平均年龄及病灶长径均小于恶性组,差异有统计学意义(P<0.05)。良性组病灶区域平扫、延迟期CT值均小于恶性组,差异有统计学意义(P<0.05);良性组病灶区域动脉期CT值、ΔCT1值(动脉期CT值和延迟期CT值差值)、ΔCT2值(门静脉期CT值和延迟期CT值差值)均低于恶性组,差异有统计学意义(P<0.05)。ΔCT2值在敏感度、特异度、约登指数方面优于CT平扫、动脉期、延迟期及ΔCT1值。结论CT平扫及增强扫描可用于良恶性胆囊息肉样病变的术前鉴别诊断。Objective To investigate the value of enhanced CT scanning in differential diagnosis of benign and malignant polypoid lesions of gallbladder.Methods Ninety-seven patients with gallbladder polypoid lesions who underwent cholecystectomy in our hospital were selected and divided into two groups according to postoperative pathological results,with 65 patients in the benign group and 32 patients in the malignant group.All patients underwent unenhanced and triphasic enhanced CT scans within 2 weeks before surgery.Clinical and imaging data were analyzed by 2 senior radiologists.Results The number of females in the two groups were greater than those of males,and there was no statistical difference between the two groups(P=0.78).The mean age and length of lesions in the benign group were lower than those in the malignant group(P<0.05).The unenhanced scan and delayed CT values of lesion area in benign group were lower than those in malignant group(P<0.05).The arterial phase CT value,ΔCT1 value(arterial stage CT value minus delayed stage CT value)andΔCT2 value(portal vein stage CT value minus delayed stage CT value)of the lesion area in benign group were all lower than those in malignant group(P<0.05).The value ofΔCT2 was superior to unenhanced CT scan,arterial stage,delay stage andΔCT1 in sensitivity,specificity and youden index.Conclusion CT unenhanced scan and enhanced scan can be used in the preoperative differential diagnosis of benign and malignant gallbladder polyps and provide basis for the choice of treatment.

关 键 词：胆囊息肉样病变 鉴别诊断 体层摄影术 X线计算机 

分 类 号：R735.8[医药卫生—肿瘤] R814.42[医药卫生—临床医学]