MSCT多期增强扫描对HCC与IHPCC的鉴别价值

Differential value of multi-slice spiral CT multi-phase enhanced scanning for hepatocellular carcinoma and intrahepatic peripheral cholangiocarcinoma

目的探究多层螺旋CT(MSCT)多期增强扫描对肝细胞癌(HCC)与肝内周围型胆管细胞癌(IHPCC)的鉴别价值。方法选取2020年1月-2022年5月期间阜阳市肿瘤医院收治的58例原发性肝癌(PLC)患者,经病理学检测诊断,其中33例为HCC,25例为IHPCC,患者均行CT平扫及MSCT多期增强扫描。采用Kappa检验,分析MSCT多期增强扫描对HCC及IHPCC的符合率、灵敏度及特异度。结果CT平扫及MSCT多期增强扫描结果与病理诊断结果的总符合率分别为72.41%(42/58)、87.93%(51/58),经Kappa一致性检验,Kappa值分别为0.438、0.757,CT平扫及MSCT多期增强扫描与病理诊断均具有一致性;MSCT多期增强扫描诊断HCC、IHPCC的的总符合率为87.93%,高于CT平扫的72.41%(P<0.05);MSCT多期增强扫描特异度高于CT平扫,漏诊率低于CT平扫(P<0.05)。结论MSCT多期增强扫描对HCC及IHPCC的诊断特异度更高,漏诊率更低,具有较高的鉴别价值。

Objective To explore the differential value of multi-phase contrast-enhanced multi-slice spiral CT(MSCT)in hepatocellular carcinoma(HCC)and intrahepatic peripheral cholangiocarcinoma(IHPCC).Methods A total of 58 patients with primary liver cancer(PLC)admitted to Fuyang Cancer Hospital from January 2020 to May 2022 were selected.After pathological examination and diagnosis,33 cases of them were HCC and 25 cases were IHPCC.All patients underwent CT plain scan and MSCT multi-phase enhanced scanning.Kappa test was used to analyze the coincidence rate,sensitivity,and specifi city of MSCT multi-phase enhanced scanning for HCC and IHPCC.Results The total coincidence rates of CT plain scanning and MSCT multi-phase enhanced scanning and pathological diagnosis were 72.41%(42/58)and 87.93%(51/58),respectively.The Kappa consistency test showed that the Kappa values were 0.438 and 0.757,respectively.The CT plain scan and MSCT multi-phase enhanced scanning showed consistency with the pathological diagnosis.The total coincidence rate of MSCT multi-phase enhanced scanning in the diagnosis of HCC and IHPCC was 87.93%,which was higher than that of CT plain scan(72.41%)(P<0.05).The specifi city of MSCT multi-phase enhanced scanning was higher than that of CT plain scan,and the missed diagnosis rate was lower than that of CT plain scan(P<0.05).Conclusion MSCT multi-phase enhanced scanning has higher diagnostic specifi city and lower missed diagnosis rate for HCC and IHPCC,and has higher differential value.