CT与增强CT诊断腹部肿瘤腹腔转移的效果比较

Comparison of CT and enhanced CT in the diagnosis of peritoneal metastasis of abdominal tumor

目的探讨CT与增强CT诊断腹部肿瘤腹腔转移的临床效果。方法回顾性分析160例疑似腹部肿瘤腹腔转移患者的临床资料,将CT检查作为对照组,增强CT检查作为观察组,以手术病理结果为金标准,比较两组种植灶指标、转移部位诊断符合率、诊断效能。结果观察组最小种植灶面积(1.04±0.56)cm^(2)、种植灶长度(4.07±0.78)cm、种植灶宽度(3.59±1.54)cm均小于对照组的(2.73±1.02)cm^(2)、(6.18±1.46)cm、(5.28±2.02)cm,差异有统计学意义(P<0.05)。观察组转移部位诊断符合率95.31%明显高于对照组的78.91%,差异有统计学意义(P<0.05)。病理结果显示,阳性128例,阴性32例;观察组中,阳性124例(真阳性122例,假阳性2例),阴性36例(真阴性30例,假阴性6例);对照组中,阳性109例(真阳性101例,假阳性8例),阴性51例(真阴性24例,假阴性27例)。观察组的诊断敏感性为95.31%(122/128),特异性为93.75%(30/32),准确性为95.00%(152/160),阳性预测值为98.39%(122/124),阴性预测值为83.33%(30/36);对照组的诊断敏感性为78.91%(101/128),特异性为75.00%(24/32),准确性为78.13%(125/160),阳性预测值为92.66%(101/109),阴性预测值为47.06%(24/51)。观察组敏感性、特异性、准确性、阳性预测值、阴性预测值均高于对照组,差异有统计学意义(P<0.05)。结论增强CT诊断腹部肿瘤腹腔转移的效果更好,可提高诊断的敏感性、特异性及准确性,能够为临床诊治提供更多的信息,值得推广使用。

Objective To discuss the clinical effect of CT and enhanced CT in the diagnosis of peritoneal metastasis of abdominal tumor.Methods The clinical data of 160 patients with suspected peritoneal metastasis of abdominal tumor were retrospectively analyzed.Patients with CT examination were used as the control group and those with enhanced CT examination were used as the observation group.The surgical and pathological results were used as the gold standard to compare the index of implans,the diagnostic coincidence rate of the metastatic site,and the diagnostic efficiency between the two groups.Results The minimum area,length and wideth of the implants were(1.04±0.56)cm^(2),(4.07±0.78)cm,and(3.59±1.54)cm in the observation group,which were smaller than(2.73±1.02)cm^(2),(6.18±1.46)cm,and(5.28±2.02)cm in the control group,and the differences were statistically significant(P<0.05).The diagnostic coincidence rate of the metastatic site in the observation group was 95.31%,which was significantly higher than 78.91%in the control group,and the difference was statistically significant(P<0.05).The pathological results showed 128 positive cases and 32 negative cases;in the observation group,there were 124 positive cases(122 true positive cases and 2 false positive cases)and 36 negative cases(30 true negative cases and 6 false negative cases);in the control group,there were 109 positive cases(101 true positives and 8 false positives)and 51 negative cases(24 true negatives and 27 false negatives).In the observation group,the diagnostic sensitivity was 95.31%(122/128),the specificity was 93.75%(30/32),the accuracy was 95.00%(152/160),the positive predictive value was 98.39%(122/124),and the negative predictive value was 83.33%(30/36);in the control group,the diagnostic sensitivity was 78.91%(101/128),the specificity was 75.00%(24/32),the accuracy was 78.13%(125/160),the positive predictive value was 92.66%(101/109),and the negative predictive value was 47.06%(24/51).The diagnostic sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Enhanced CT has better effect in the diagnosis of peritoneal metastasis of abdominal tumor,which can improve the sensitivity,specificity and accuracy of diagnosis,and provide more information for clinical diagnosis and treatment,which is worthy of popularization and application.