CT平扫与MSCT双期增强鉴别早期肝细胞癌效果研究

The effect of CT plain scan and MSCT double stage enhancement in differentiating small cell carcinoma of liver

目的探讨CT平扫与多层螺旋CT(MSCT)双期增强鉴别早期肝细胞癌效果。方法选取2019年1月-2020年6月河南科技大学第一附属医院就诊的114例早期肝细胞癌患者,依照检查方式的不同将患者分为对照组(n=58)与研究组(n=56),分别采用CT平扫检查与MSCT双期增强扫描检查,对比两组患者临床检查结果。结果以病理活检为金标准,研究组早期肝细胞癌动脉期准确率为92.86%,门脉期准确率83.93%;对照组早期肝细胞癌准确率65.52%。研究组早期肝细胞癌诊断准确率高于对照组(P<0.05);研究组患者进行中MSCT双期增强后低密度影与等密度影占比各为3.58%,高密度影占比92.86%;肿瘤内密度均匀占比64.29%,肿瘤内密度不均占比35.71%;肿瘤边界清晰占比73.21%,肿瘤边界不清晰占比26.76%。对照组Ct平扫后低密度影占比81.03%,等密度影占比15.52%,高密度影占比3.45%;肿瘤内密度均匀占比82.76%,肿瘤内密度不均占比17.24%;肿瘤边界清晰占比36.21%,肿瘤边界不清晰占比63.79%。对照组患者与研究组患者动脉期、门脉期肿瘤与肝脏密度差存在差异(P<0.05),其中门脉期密度差最大,对照组最小。结论MSCT双期增强扫描在诊断早期肝细胞癌中诊断准确率显著高于CT平扫,可进行临床推广使用,诊断价值较高。

Objective To explore the effect of plain CT and multi-slice spiral CT(MSCT)double-stage enhancement in differentiating small cell carcinoma of liver.Methods 114 patients with SCLC admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2019 to June 2020 were selected and divided into control group(n=58)and study group(n=56)according to different examination methods.Plain CT scan and MSCT double-phase enhanced scan were used respectively to compare the clinical examination results of the two groups.Results With pathological biopsy as the gold standard,the arterial-stage accuracy rate of the study group was 92.86%,that of the portal stage was 83.93%and that of the control group was 65.52%.Diagnostic accuracy of small cell carcinoma of liver in the study group was higher than that in the control group(P<0.05).The low-density and isodensity shadows accounted for 3.58%and the high-density shadow accounted for 92.86%after the double-stage enhancement of MSCT in the study group.The uniform density in tumor accounted for 64.29%,while the uneven density in tumor accounted for 35.71%.Clear tumor boundaries accounted for 73.21%,and unclear tumor boundaries accounted for 26.76%.In the control group,after plain Ct scan,low-density shadow accounted for 81.03%,isodensity shadow accounted for 15.52%,and high-density shadow accounted for 3.45%.The proportion of uniform density in tumor was 82.76%and non-uniform density in tumor was 17.24%.Clear tumor boundaries accounted for 36.21%,and unclear tumor boundaries accounted for 63.79%.There were differences in tumor and liver density between the control group and the study group in arterial and portal stage(P<0.05),in which the difference was the largest in portal stage and the smallest in the control group.Results The detection rate of MSCT double-phase enhanced scan in the diagnosis of small cell carcinoma of liver is significantly higher than that of CT plain scan,which can be widely used in clinical practice and has high diagnostic value.