MSCT对乙肝肝硬化再生结节与小肝癌的鉴别诊断价值

Study on the Value of MSCT in Differential Diagnosis of Regenerative Nodules in Type B Liver Cirrhosis and Small Hepatocellular Carcinoma

目的探讨基于动态增强及计算机后处理的多层螺旋CT(Multislice Spiral CT,MSCT)对乙肝肝硬化再生结节与小肝癌的鉴别诊断价值。方法回顾性分析本院2019年6月至2021年10月经穿刺或手术病理检查证实的56例乙肝肝硬化再生结节患者(结节组)和55例小肝癌患者(肝癌组)的临床资料,比较2组患者MSCT平扫结果与动脉期、门静脉期、延迟期增强扫描及计算机后处理的MSCT结果,分析基于三期动态增强及计算机后处理的MSCT对乙肝肝硬化再生结节与小肝癌的诊断灵敏度、特异度、准确度,并采用Kappa行一致性检验。结果2组性别、年龄、体质量指数比较无统计学差异(P>0.05)。基于动态增强及计算机后处理的MSCT鉴别乙肝肝硬化再生结节和小肝癌的灵敏度分别为96.43%、92.73%,特异度分别为92.73%、96.43%,准确度均为94.59%;2组平扫期、延迟期的MSCT值比较无统计学差异(P>0.05),小肝癌组门静脉期的MSCT值低于结节组(P<0.05),动脉期MSCT值高于结节组(P<0.05)。结论基于动态增强及计算机后处理的MSCT对乙肝肝硬化再生结节与小肝癌的有良好的鉴别诊断价值,可为临床医师判断病情及制定合适的治疗方案提供客观依据。

Objective To explore the value of multislice spiral CT(MSCT)based on dynamic contrast enhancement and computer post-processing in the differential diagnosis of regenerative nodule of type B liver cirrhosis and small hepatocellular carcinoma.Methods The clinical data of 56 patients with regenerative nodule of type B liver cirrhosis(nodule group)and 55 patients with small hepatocellular carcinoma(liver cancer group)confirmed by puncture or surgical pathology from June 2019 to October 2021 were retrospectively analyzed.The results of MSCT plain scan,arterial phase,portal vein phase,delayed phase enhanced scan and computer post-processing were compared between the two groups.The sensitivity,specificity and accuracy of MSCT based on three-phase dynamic enhancement and computer post-processing in the regenerative nodule of type B liver cirrhosis and small hepatocellular carcinoma was analyzed.Kappa was used for consistency test.Results There was no significant difference in gender,age and body mass index between the two groups(P>0.05).The sensitivity of MSCT based on dynamic enhancement and computer post-processing to differentiate regenerative nodules of type B liver cirrhosis and small hepatocellular carcinoma were 96.43%and 92.73%respectively,and the specificity were 92.73%and 96.43%respectively,and the accuracy were bath 94.59%.There was no significant difference in MSCT values between the two groups in the non scanning period and the delayed period(P>0.05).The value of MSCT in portal vein phase in liver cancer group was lower than that in nodule group(P<0.05),and the value of MSCT in arterial phase was higher than that in nodule group(P<0.05).Conclusion MSCT based on dynamic contrast and computer post-processing has a good differential diagnostic value for regenerative nodule of type B liver cirrhosis and small hepatocellular carcinoma,which can provide objective evidence for clinicians to determine the condition and formulate appropriate treatment options.