增强CT扫描对TAEC术后原发性肝癌患者疗效评估研究

Evaluation of efficacy of enhanced CT scanning in patients with primary liver cancer after TAEC

目的探讨增强CT扫描对TAEC术后原发性肝癌患者的疗效。方法选取濮阳市安阳地区医院微创介入科于2020年2月1日至2023年2月1日收治的97例(108个病灶)原发性肝癌患者作为研究对象。全部患者采取TAEC手术治疗,术后行增强CT扫描及数字减影血管造影(DSA)检查,以DSA诊断结果作为“金标准”,采用增强CT扫描技术对原发性肝癌(primary liver cancer,PLC)患者行介入术后的疗效进行评估,分析其诊断准确性、特异性及灵敏性等,以评价该技术的应用价值。结果DSA检查发现,97例患者共计108个病灶。其中,47个(43.92%)病灶完全灭活,61个(56.08%)病灶残留。经增强CT扫描发现,97例患者共计108个病灶。其中,46个(42.59%)病灶完全灭活,62个(57.41%)病灶残留;增强扫描CT扫描诊断PLC患者TAEC术治疗后阳性病灶准确度为95.37%(103/108),灵敏度为96.72%(59/61),特异度93.62%(44/47),阳性预测值为95.16%(59/62),阴性预测值为95.65%(44/46);与CT平扫相比,增强CT扫描对PLC患者TAEC术后病灶大小、供血动脉来源的诊断灵敏度、特异度均显著增高(P<0.05);在PLC患者TAEC术后复发方面,增强CT扫描与DSA检查结果差异不显著(P>0.05)。以DSA检查为金标准,增强CT扫描检查患者术后复发的灵敏度为98.46%(64/65),特异度为97.67%(42/43),阳性预测值为98.44%(63/64),阴性预测值为95.45%(42/44)。结论增强CT扫描对TAEC术后原发性肝癌患者评估具有较高的应用价值。

Objective To investigate the effect of enhanced CT scanning on primary liver cancer patients after TAEC.Methods Ninety-seven patients(108 lesions)with primary liver cancer admitted to the minimally invasive interven⁃tion department of our hospital from February 1,2020 to February 1,2023 were selected as the research objects.All pa⁃tients were treated with TAEC surgery,and underwent enhanced CT scanning and digital subtraction angiography(DSA)examination after surgery.With DSA diagnosis as the"gold standard",enhanced CT scanning technology was used to e⁃valuate the efficacy of interventional surgery in patients with primary liver cancer(PLC).The diagnostic accuracy,spe⁃cificity and sensitivity were analyzed to evaluate the application value of the technique.Results DSA showed 108 le⁃sions in 97 patients.Among them,47(43.92%)lesions were completely inactivated and 61(56.08%)lesions re⁃mained.Enhanced CT scan revealed 108 lesions in 97 patients.Among them,46(42.59%)lesions were completely inactivated and 62(57.41%)lesions remained.The accuracy,sensitivity,specificity and positive predictive value of enhanced CT scanning in the diagnosis of positive lesions in PLC patients after TAEC were 95.37%(103/108),96.72%(59/61),93.62%(44/47)and 95.16%(59/62)respectively.The negative predictive value was 95.65%(44/46).Compared with plain CT scan,enhanced CT scan significantly increased the diagnostic sensitivity and speci⁃ficity of lesion size and donor artery source in PLC patients after TAEC(P<0.05).There was no significant difference between enhanced CT scan and DSA in the recurrence of PLC patients after TAEC(P>0.05).Using DSA as the gold standard,the sensitivity and specificity of enhanced CT scanning for postoperative recurrence were 98.46%(64/65),97.67%(42/43),98.44%(63/64)and 95.45%(42/44)respectively.Conclusion Enhanced CT scan has high application value in the evaluation of primary liver cancer patients after TAEC.