多层螺旋CT检查在鉴别诊断原发性肝癌与肝脏局灶性结节增生中的应用价值

The Application Value of Multi-Slice Spiral CT Examination in Differential Diagnosis of Primary Liver Cancer and Focal Nodular Hyperplasia of the Liver

目的 探讨多层螺旋CT(MSCT)检查在鉴别诊断原发性肝癌与肝脏局灶性结节增生(FNH)中的应用价值。方法 选取我院2019年1月至2022年12月收治的肝脏占位性病变患者83例,均开展MSCT检查,统计原发性肝癌、FNH检出情况,并以肝穿刺活检为金标准,分析MSCT鉴别诊断原发性肝癌与FNH的诊断效能;采用Kappa检验验证MSCT鉴别诊断与肝穿刺活检的一致性。结果 83例肝脏占位性病变患者,经肝穿刺活检证实41例为原发性肝癌,42例为FNH;经MSCT检出原发性肝癌40例,FNH 43例,原发性肝癌检出率为97.56%;MSCT鉴别诊断原发性肝癌与FNH的灵敏度为95.12%、特异度为97.62%、准确度为96.39%、阳性预测值为97.50%、阴性预测值为95.35%;Kappa检验显示,MSCT鉴别诊断与肝穿刺活检的Kappa值为0.928,一致性极高。结论 MSCT检测在鉴别诊断原发性肝癌与FNH中价值高,可提高诊断准确性,便于早期开展针对性治疗,以更好改善患者预后。

Objective explore the application value of multi-slice spiral CT(MSCT)in early differential diagnosis of primary liver cancer and focal nodular hyperplasia(FNH)of the liver.Methods A total of 83 patients with liver space occupying lesions admitted to our hospital from January 2019 to December 2022 were selected for MSCT examination,and the detection of primary liver cancer and FNH was statistically analyzed.The diagnostic efficacy of MSCT in distinguishing primary liver cancer and FNH was analyzed using liver biopsy as the gold standard;Kappa test was used to verify the consistency between MSCT differential diagnosis and liver biopsy.Results Among the 83 patients with liver space occupying lesions,41 were confirmed as primary liver cancer by liver biopsy,and 42 were confirmed as FNH;40 cases of primary liver cancer and 43 cases of FNH were detected by MSCT,and the detection rate of primary liver cancer was 97.56%;The sensitivity of MSCT in distinguishing primary liver cancer from FNH was 95.12%,specificity was 97.62%,accuracy was 96.39%,positive predictive value was 97.50%,and negative predictive value was 95.35%;The Kappa test showed that the differential diagnosis of MSCT was highly consistent with liver biopsy(Kappa value was 0.928).Conclusions MSCT detection has high value in differential diagnosis of primary liver cancer and FNH,can improve diagnostic accuracy,facilitate early targeted treatment,and better improve patient prognosis.