多层螺旋CT三期增强扫描鉴别原发性肝癌与肝海绵状血管瘤的诊断效能评估

Evaluation of the diagnostic efficacy of multi-slice spiral CT in the differential diagnosis of primary hepatic carcinoma and heptic cvernous hngiom

目的评估多层螺旋CT(MSCT)三期增强扫描鉴别原发性肝癌(PHC)、肝海绵状血管瘤(HCH)的诊断效能。方法回顾性分析2016年10月至2020年10月于本院就诊的87例疑似肝癌患者的临床资料,所有患者均经过MSCT三期增强扫描检查,病理组织均送至病理实验室进行良恶性检测,分析MSCT三期增强扫描的诊断效能,比较不同性质病灶增强扫描影像特征,比较PHC与HCH病灶大小、病灶分布情况及不同分期增强扫描对PHC病灶的检出率。结果MSCT三期增强扫描诊断PHC的灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为93.33%、98.00%、95.79%、97.67%、94.23%,Kappa值为0.915;MSCT三期增强扫描诊断HCH的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为98.00%、93.33%、95.79%、94.23%、97.67%,Kappa值为0.915,均与病理诊断结果一致性较好;多数PHC病灶在三期增强扫描中强化呈现“高-低-低”的变化趋势,HCH总体呈现向心进展性变化趋势;MSCT三期增强扫描检出的PHC病灶平均大小及分布位置与HCH比较差异无统计学意义;动脉期、门静脉期、延迟期增强扫描对PHC病灶的检出率比较差异无统计学意义。结论MSCT三期增强扫描可通过对比病灶内强化程度变化趋势鉴别诊断PHC、HCH,诊断效能较高。

Objective To evaluate the diagnostic efficacy of multi-slice spiral CT(MSCT)in the differential diagnosis of primary hepatic carcinoma(PHC)and heptic cvernous hngiom(HCH).Methods The clinical data of 87 patients with suspected liver cancer treated in our hospital from October 2016 to October 2020 were retrospectively analyzed,all patients underwent stageⅢmulti-slice spiral CT scan,and the pathological tissues were sent to the pathology laboratory for benign and malignant detection,the diagnostic efficiency of stageⅢmulti-slice spiral CT scan were analyed,the imaging features of lesions with different characteristics were compared,the size and distribution of lesions and the detection efficiency of PHC lesions with different stages of enhanced scan were compared.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of MSCT enhanced scanning for PHC diagnosis were 93.33%,98.00%,95.79%,97.67%and 94.23%,respectively,and Kappa value was 0.915;the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of MSCT enhanced scanning in the diagnosis of HCH were 98.00%,93.33%,95.79%,94.23%and 97.67%,respectively,and Kappa value was 0.915,all of which were in good consistency with pathological diagnosis results.Most PHC lesions showed a trend of"high-low-low"enhancement in the third phase enhanced scan,and HCH showed a progressive trend of centripetal change.There was no significant difference in the average size and location of PHC lesions detected by MSCT compared with HCH.There was no significant difference in the detection rate of PHC lesions by enhanced scanning in arterial phase,portal vein phase and delayed phase.Conclusion MSCT can differentiate PHC and HCH by comparing the trend of enhancement degree in the lesion,and it has high diagnostic efficiency.