64层螺旋CT及超声检查对肝癌与局灶性增生的诊断价值

The diagnostic value of 64-slice spiral CT and ultrasound in liver cancer and focal hyperplasia

目的探讨64层螺旋CT及超声检查对肝癌及局灶性增生结节的诊断价值.方法对60例经病理诊断确诊为肝癌或局灶性增生结节患者(原发性肝癌28例、转移性肝癌8例、肝局灶性增生结节24例)的超声及64层螺旋CT检查结果进行统计分析.结果本组患者超声诊断的敏感度(58.3%)、特异度(66.7%)、诊断符合率(61.7%)显著低于64层螺旋CT检查诊断(91.7%、91.7%、91.7%)(P<0.05或0.01).64层螺旋CT检查,动脉期、门脉期扫描,肝癌患者能谱定量参数值病灶与周围肝组织碘浓度、标准化碘浓度均显著低于局灶性增生结节患者(P<0.01).结论64层螺旋CT对肝癌及局灶性增生结节的诊断敏感度、特异度及诊断符合率显著高于超声检查,肝癌及局灶性增生结节在64层螺旋CT中表现出病灶与周围肝组织碘浓度、标准化碘浓度不同,64层螺旋CT对鉴别诊断有较高的临床价值.

Objective To explore the diagnostic value of 64-slice spiral CT and ultrasound in liver cancerand focal hyperplasia.Methods Ultrasound and 64-slice spiral CT examination results of 60 patients diag-nosed with pathological diagnosis as liver cancer or focal hyperplastic nodules(28 cases of primary livercancer,8 metastatic liver cancers,and 24 cases of liver focal hyperplastic nodules)were statistically ana-lyzed.Results The sensitivity(58.3%),specificity(66.7%)and diagnostic coineidence rate(61.7%)ofultrasound diagnosis in this group of patients were significantly lower than those of 64-slice spiral CT ex-amination(91.7%,91.7%,91.7%)(P<0.05 or 0.01).64-slice spiral CT examination,arterial phaseand portal phase scaning,quantitative parameter values of energy spectrum of liver cancer patients andthe surrounding liver tissue iodine concentration and standardized iodine concentration were significantlylower than those of focal hyperplastic nodules(P<0.01).Conclusions The diagnostic sensitivity,speci-ficity and diagnostic coincidence rate of 64-slice spiral CT for liver cancer and focal hyperplastic nodules issignificantly higher than that of ultrasound examination.Liver cancer and focal hyperplastic nodulesshowed different iodine concentration and standardized iodine concentration in the lesion and surroundingliver tissues in 64-slice spiral CT.64-slice spiral CT has high clinical value for differential diagnosis.