MSCT增强扫描结合MPR对胆管细胞癌的诊断价值分析

Diagnostic Value of MSCT Enhanced Scanning Combined with MPR in Cholangiocarcinoma

目的:探讨多层螺旋CT(MSCT)增强扫描结合多平面重建技术(MPR)对胆管细胞癌的诊断价值。方法:选取2018年2月至2020年2月我院接诊的疑似胆管细胞癌患者108例,所有患者均行MSCT增强扫描、MPR检查,以手术病理检查结果为金标准,分析MSCT增强扫描、MPR、MSCT增强扫描结合MPR诊断胆管细胞癌效能以及与手术病理检查一致性。结果:108例患者中胆管细胞癌88例(81.48%),非胆管细胞癌20例(18.52%);MSCT增强扫描结合MPR诊断胆管细胞癌敏感度、特异度和准确度高于单一检查,差异有统计学意义(P<0.05);kappa检验显示:MSCT增强扫描与病理诊断的一致性不佳(kappa值=0.242,P=0.010);MPR与病理诊断的一致性尚可(kappa值=0.412,P=0.000);MSCT增强扫描结合MPR与病理诊断的一致性良好(kappa值=0.849,P=0.000)。结论:MSCT增强扫描结合MPR诊断胆管细胞癌具有较高的敏感度、特异度和准确度,与病理诊断一致性较高,可指导临床治疗,改善患者预后。

Objective:To investigate the value of multi-slice spiral CT(MSCT)enhanced scanning combined with multiplanar reconstruction(MPR)in the diagnosis of cholangiocarcinoma.Method:108 patients with suspected cholangiocarcinoma treated in our hospital from February 2018 to February 2020 were selected.All patients underwent MSCT enhanced scanning and MPR examination.Taking the results of surgical pathological examination as the gold standard,the efficacy of MSCT enhanced scanning,MPR,MSCT enhanced scanning combined with MPR in the diagnosis of cholangiocarcinoma and its consistency with surgical pathological examination were analyzed.Result:Among the 108 patients,88 cases(81.48%)were cholangiocarcinoma and 20 cases(18.52%)were non cholangiocarcinoma;The sensitivity,specificity and accuracy of MSCT enhanced scanning combined with MPR in the diagnosis of cholangiocarcinoma were higher than those of single examination(P<0.05);Kappa test showed that the consistency between MSCT enhanced scan and pathological diagnosis was poor(kappa value=0.242,P=0.010);The consistency between MPR and pathological diagnosis was acceptable(kappa value=0.412,P=0.000);MSCT enhanced scan combined with MPR had good consistency with pathological diagnosis(kappa value=0.849,P=0.000).Conclusion:MSCT enhanced scanning combined with MPR in the diagnosis of cholangiocarcinoma has high sensitivity,specificity and accuracy,and has high consistency with pathological diagnosis.It can guide clinical treatment and improve the prognosis of patients.