多期增强螺旋CT与超声造影对原发性肝癌的影像学诊断效能对照分析

Contrast Analysis of Multi-phase Contrastenhanced Spiral CT and Contrast-enhanced Ultrasound in Imaging Diagnosis of Primary Hepatocellular Carcinoma

目的探讨多期增强螺旋CT与超声造影对原发性肝癌的影像学诊断效能。方法选取2016年1月至2018年8月于我院就诊治疗的84例原发性肝癌患者作为研究对象,收集所有患者临床病理、手术以及影像学资料,且以病理学检查结果为金标准,比较不同检查方法对原发性肝癌的检出和诊断率,并整理分析不同检查方法中患者的图像表现特征。结果多期增强螺旋CT检查对原发性肝癌病灶检出率和诊断符合率与超声造影比较均无差异(P>0.05),而多期增强螺旋CT+超声造影检查对原发性肝癌病灶检出率(100.00%)和诊断符合率(98.81%)均显著高于超声造影和MSCT单项检查(P<0.05)。在多期增强螺旋CT检查中共检出病灶80个,有62个病灶存在包膜,且主要以圆形或类圆形影呈现,其中12个病灶表现为低密度的分叶或不规则形。增强扫描中,80个病灶在动脉期均表现为不均匀增强,而在门脉期病灶增强程度减低,在延迟期未见明显增强。超声造影检查共检出原发性肝癌病灶76个,病灶大多数表现为类圆形的低回声,常伴有包膜及暗晕,所有病灶在动脉期均表现为高增强,且表现为周边先增强后向内部延伸。在门静脉其病灶从高增强逐渐降低为等增强表现,周围肝组织回声略增强,至延迟期病灶以低增强主要表现。结论多期增强螺旋CT与超声造影对原发性肝癌的检出诊断率均较高,但多期增强螺旋CT与超声造影联合检查其诊断价值更为显著,可多方位、多角度以及更清晰的显示病灶情况,更有利于临床医生进行治疗。

Objective To evaluate the imaging diagnostic efficacy of multi-phase contrastenhanced spiral CT and contrast-enhanced ultrasound in primary hepatocellular carcinoma.Methods 84 patients with primary liver cancer treated in our hospital from January 2016 to August 2018 were selected as research objects.All patients with clinical pathology,surgery and imaging data were collected,and the pathological examination results as the gold standard.Different examination methods for primary liver cancer detection and diagnosis rate were compared,and the features of the image with different examination methods are analyzed.Results The detection rate and diagnostic coincidence rate of multi-phase enhanced spiral CT for primary liver cancer were not different from those of contrast-enhanced ultrasound(P>0.05),while the detection rate of multi-phase enhanced spiral CT combined with contrast-enhanced ultrasound for primary liver cancer(100.00%)and diagnostic coincidence rate(98.81%)were significantly higher than those of contrast-enhanced ultrasound and MSCT(P<0.05).In multi-phase contrast-enhanced spiral CT examination,80 lesions were detected,62 lesions had capsule,and mainly presented as round or quasi-circular shadow,of which 12 lesions showed lobulated or irregular low density.In contrast-enhanced scans,80 lesions showed uneven enhancement in arterial phase,while in portal phase,the enhancement was decreased,and no significant enhancement was observed in delayed phase.Contrast-enhanced ultrasonography detected 76 primary hepatocellular carcinoma lesions.Most of the lesions were roundlike hypoechoic,often accompanied by capsule and dark halo.All lesions showed high enhancement in arterial phase,with peripheral enhancement first and then extended to the interior.In portal vein,the lesions gradually decreased from high enhancement to equal enhancement,and the echo of surrounding liver tissue increased slightly.In delayed phase,the main manifestation was low enhancement.Conclusion Multi phase helical CT and ultrasound imaging of hepatocellular carcinoma were higher detection rate of diagnosis,but the multi phase enhanced spiral CT and contrast-enhanced ultrasound in the diagnostic value of joint inspection is more significant to multi angles and display the lesions more clearly,more conducive to clinical doctors for treatment.