卵巢癌肝周转移的多层螺旋CT诊断研究

Perihepatic metastases:detection with MDCT in patients with ovarian cancer

目的研究卵巢癌肝周转移的CT表现特点;并探讨CT诊断肝周转移灶侵犯肝实质的准确性。方法以89例可以进行手术治疗的卵巢癌患者为研究对象,三位影像科医师对其术前CT结果进行回顾性分析,观察并记录是否存在卵巢肝周转移、转移灶特点及转移灶是否侵犯肝实质。以术中观察及病理检验结果作为判断标准,判断CT诊断卵巢癌肝周转移的真实性。结果有36位患者存在肝周转移,转移灶共有58处,其中51处未侵及肝实质,其余的7处侵及肝实质。CT判断卵巢癌患者是否存在肝周转移灶的敏感度和特异度分别是89%、98%;CT诊断转移灶是否侵及肝实质的结果与病理检验的结果无明显统计学差异。结论利用CT检查可准确判断卵巢癌是否存在肝周转移,以及转移灶是否侵及肝实质。有助于临床医师制定正确的诊疗方案。

Objective To study the appearances of perihepatic metastases in patients with ovarian cancer and to determine the validity of CT for the diagnosis of perihepatic metastases with and those without liver parenchymal invasion（LPI） in those patients.Methods 89 patients with ovarian cancer formed the study group.Three radiologists retrospectively recorded presence of perihepatic metastases,characters of the images of perihepatic metastases,and presence of LPI by perihepatic metastases visible on CT images.Surgeons＇ detailed intraoperative notes and pathology reports used as reference standards.Sensitivities and specialities for detecting the presence of perihepatic metastases were calculated.Results There were 58 perihepatic metastases,which were shown by pathologic examination results in 36 of 89 patients.Fifty-one of 58 perihepatic metastases did not show signs of LPI and seven did.Sensitivity and specialities were 89% and 98% for detecting the presence of perihepatic metastases.The CT examination results and the pathologic examination results showed good agreement.Conclusion CT could be helpful in treatment planning in patients with ovarian cancer because it can be used to detect perihepatic metastases and allow for distinction between metastases that invade the liver and those that do not.