MSCT联合螺旋CT增强扫描在肝脏肿瘤类型中的鉴别价值分析

Analysis of the Differential Value of MSCT Combined with Helical CT Enhanced Scanning in Liver Tumor Types

目的探讨与分析多层螺旋CT(multislice computer tomography,MSCT)联合螺旋CT增强扫描在体检患者鉴别肝脏肿瘤类型中的价值。方法选择2016年9月~2018年12月在32261部队放射科诊治的肝脏肿瘤80例作为研究对象,所有患者都给予MSCT联合螺旋CT增强扫描,记录影像学特征并通过与病理诊断的对比判断诊断价值。结果在80例患者中,病理诊断为肝脏良性肿瘤43例(良性肿瘤组),肝脏恶性肿瘤37例(恶性肿瘤组)。恶性肿瘤组的CT图像显示肿瘤出血、坏死囊变、钙化占比分别为56.76%、59.46%、64.86%,明显高于良性肿瘤组的13.95%、9.30%、11.62%(P<0.05)。恶性肿瘤组的CT增强扫描动脉期、门脉期、平衡期的CT值明显高于良性肿瘤组(P<0.05)。恶性肿瘤组的CT增强方式多为不均匀强化(n=32),良性肿瘤组多为均匀强化(n=40),对比差异有统计学意义(P<0.05)。MSCT联合螺旋CT增强扫描判断为肝脏良性肿瘤42例,肝脏恶性肿瘤38例,MSCT联合螺旋CT增强扫描判鉴别诊断肝脏肿瘤良恶性的敏感度与特异度分别为97.67%和100.00%,受试者工作特征(receiver operating characteristic,ROC)曲线显示MSCT联合螺旋CT增强预测肝脏良恶性肿瘤的最大曲线下面积为0.719。结论肝脏良恶性肿瘤的形态特征、强化特征、CT值均可作为鉴别参数,MSCT联合螺旋CT增强扫描判鉴别诊断肝脏肿瘤良恶性具有重要的意义,具有临床应用价值。

Objective To explore and analysis the values of multislice computer tomography(MSCT)combined with enhanced helical CT scan in differentiating liver tumor types in physical examination patients.Methods From September 2016 to December 2018,a total of 80 cases of liver tumors diagnosed and treated in 32261 Army Radiology Department were selected as the research subjects.All patients were given MSCT combined with helical CT enhanced scanning,and the imaging features were recorded and the diagnostic value were judged.Results In the 80 patients,43 cases were pathologically diagnosed as benign liver tumors(benign tumor group),and 37 cases were malignant liver tumors(malignant tumor group).The proportion of CT tumor hemorrhage,necrosis and cystic degeneration and calcifi cation in the malignant tumor group(56.76%,59.46%,64.86%)were signifi cantly higher than that in the benign tumor group(13.95%,9.30%,11.62%)(P<0.05).The CT value of the CT enhanced scan in the malignant tumor groupof arterial phase,portal phase,equilibrium phase were signifi cantly higher than that in the benign tumor group(P<0.05).The CT enhancement mode of malignant tumor group were mostly heterogeneous enhancement(n=32),while benign tumor groupwere mostly homogeneous enhancement(n=40),and there were signifi cant diff erence in contrast(P<0.05).MSCT combined with helical CT enhanced scanning were judged to be 42 cases of benign liver tumors and 38 cases of liver malignant tumors.The sensitivity and specifi city of MSCT combined with helical CT enhanced scanning for diff erential diagnosis of benign and malignant liver tumors were 97.67%and 100.00%.The receiver operating characteristic(ROC)curve showed that the maximum area under the curve of MSCT combined with helical CT enhancement for predicting benign and malignant liver tumors was 0.719.Conclusion Morphological features,enhancement features,and CT values of benign and malignant liver tumors can be used as differential parameters.MSCT combined with helical CT enhanced scanning has important signifi cance in the diff erential diagnosis of benign and malignant liver tumors,and has clinical application value.