多层螺旋CT在胆道恶性肿瘤诊断中的应用价值

Application Value of Multi-slice Spiral CT in Diagnosis of Biliary Tract Malignant Tumor

目的研究多层螺旋CT在胆道恶性肿瘤诊断中的应用价值。方法选取2020年6月-2021年6月我院诊治的42例疑似胆道恶性肿瘤患者为研究对象,均行多层螺旋CT检查,以病理检查结果为金标准,分析胆道恶性肿瘤诊断效能、不同类型恶性肿瘤诊断效能及征象特点。结果多层螺旋CT诊断敏感度为94.44%、特异性为71.43%、阳性预测值为94.59%、阴性预测值77.78%、准确率为97.14%。胆囊癌诊断准确率、特异性、敏感度均高于肝内胆管癌和肝外胆管癌,且肝外胆管癌高于肝内胆管癌(P<0.05);恶性肿瘤胆总管、胰管扩张、边界不清晰、强化不明显、低密度征象占比高于良性肿瘤(P<0.05);胆囊癌CT主要表现为厚壁型、肿块型、腔内结节型,在胆囊壁厚度、是否囊腔积液、是否有结节、增强后是否强化方面存在差异;肝内胆管癌和肝外胆管癌主要表现为肿块型、管壁浸润型、腔内乳头型,在肝块密度、形状、边界、强化表现方面存在差异。结论多层螺旋CT在胆道恶性肿瘤诊断与鉴别诊断效能较高,可有效鉴别胆囊癌、肝内胆管癌和肝外胆管癌,并且良性和恶性肿瘤CT征象存在差异,对胆道恶性肿瘤诊断具有重要的价值。

Objective To study the application value of multi-slice spiral CT in the diagnosis of biliary malignant tumors.Methods From June 2020 to June 2021,42 patients with suspected biliary tract malignant tumors diagnosed and treated in our hospital were selected as subjects.All patients underwent multi-slice spiral CT examination.With pathological examination results as the gold standard,the diagnostic efficacy of biliary tract malignant tumors and the diagnostic efficacy and signs of different types of malignant tumors were analyzed.Results The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of multi-slice spiral CT were 94.44%,71.43%,94.59%,77.78%and 97.14%,respectively.The diagnostic accuracy,specificity and sensitivity of gallbladder cancer were higher than those of intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma,and those of extrahepatic cholangiocarcinoma were higher than those of intrahepatic cholangiocarcinoma(P<0.05).The proportions of common bile duct and pancreatic duct dilatation,unclear boundary,unobvious enhancement and low density signs in malignant tumors were higher than those in benign tumors(P<0.05).The CT manifestations of gallbladder carcinoma were mainly thick wall type,mass type and intracavity nodule type,there were differences in the thickness of gallbladder wall,whether there was cystic effusion,whether there was nodule and whether there was enhancement after enhancement.Intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma mainly presented as mass type,wall infiltrating type and intraluminal papillary type,there were differences in density,shape,boundary and enhancement of hepatic mass.Conclusion Multi-slice spiral CT has high efficiency in the diagnosis and differential diagnosis of biliary tract malignant tumors,which can effectively identify gallbladder cancer,intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma,and there are differences in CT signs between benign and malignant tumors,it has important value in the diagnosis of biliary tract malignant tumors.