探讨CT对乙肝肝硬化相关性小肝癌(SHCC)的诊断价值

The Diagnostic Value of CT in Small Hepatocellular Carcinoma(SHCC)Associated with Hepatitis B Cirrhosis

目的:评估CT诊断手段对于乙肝肝硬化相关性小肝癌(SHCC)患者的临床诊断意义。方法:选取2018年2月~2020年5月某医院诊断的47例疑似患有乙肝肝硬化相关性小肝癌的患者实行指标项目指标分析,均进行超声诊断、CT诊断、病理诊断,研究病理诊断结果详细状况、不同诊断手段对乙肝肝硬化相关性小肝癌的检测灵敏度、检测特异度、检测准确性、CT平扫诊断手段及增强扫描诊断手段对癌灶的检出结果详细状况、CT不同扫描检测时期对不同密度癌灶的检出结果详细状况。结果:47例患者中,病理诊断存在乙肝肝硬化相关性小肝癌为77.08%,确诊患者共检出癌灶46个;将病理诊断结果作为标准,超声诊断和CT诊断对乙肝肝硬化相关性小肝癌的检测灵敏度、检测特异度、检测准确性分别为83.78%、80.00%、82.98%和94.59%、90.00%、93.62%,CT诊断对乙肝肝硬化相关性小肝癌的检测灵敏度、检测特异度、检测准确性高于超声诊断(P<0.05);CT平扫诊断检出癌灶为65.52%,CT增强扫描诊断检出癌灶为93.48%,CT增强扫描诊断检出癌灶占有百分率高于CT平扫诊断(P<0.05),癌灶直径均值为(1.98±0.34)cm;平扫时、动脉期、门脉期、延迟期对各密度癌灶的整体检出百分率分别为65.52%、91.30%、71.74%、78.26%,动脉期对各密度癌灶的整体检出百分率相比平扫时、门脉期、延迟期更高(P<0.05)。结论:为乙肝肝硬化相关性小肝癌患者选用CT诊断显示出较好临床诊断效果。

Objective:To evaluate the clinical diagnostic significance of CT in the diagnosis of hepatitis B cirrhosis associated small hepatocellular carcinoma(SHCC).Methods:47 cases of suspected patients with hepatitis B cirrhosis associated small hepatocellular carcinoma(SHCC)diagnosed in a hospital from February 2018 to may 2020 were analyzed,the ultrasound diagnosis,CT diagnosis and pathological diagnosis were implemented,and the detailed status of pathological diagnosis results,detection sensitivity,the detection specificity,and detection accuracy of different diagnostic methods for hepatitis B cirrhosis associated small hepatocellular carcinoma,the detailed status of diagnosis results of CT scan and enhanced scan diagnostic means for cancer lesions,and the detailed status of diagnosis results of CT scan detection in different detection period for cancer lesions with different density were studied.Results:Among the 47 patients,77.08%of the 47 patients were diagnosed with liver cirrhosis related small hepatocellular carcinoma(SHCC),and 46 cancer foci were detected in the confirmed patients;The sensitivity,specificity and accuracy of ultrasonic diagnosis and CT diagnosis were 83.78%,80.00%,82.98%and 94.59%,90.00%,93.62%,respectively.The results showed that the sensitivity,specificity and accuracy of CT detection for small hepatocellular carcinoma associated with hepatitis B cirrhosis were higher than those of ultrasound diagnosis(P<0.05);65.52%of cancer lesions were detected by CT scan,93.48%were detected by enhanced CT scan,and the percentage of cancer lesions detected by enhanced CT was higher than that of plain CT(P<0.05).The mean diameter of cancer lesions was(1.98±0.34)cm.The overall detection percentage of each density of cancer lesions in plain scan,arterial phase,portal vein phase and delayed phase was 65.52%,91.30%,71.74%and 78.26%,respectively,and the overall detection percentage of arterial phase to each density of cancer lesions was higher than that of plain scan,portal vein phase and delayed phase(P<0.05).Conclusion:The CT diagnosis method has better clinical diagnosis effect for patients with small hepatocellular carcinoma associated with hepatitis B cirrhosis.