超声造影联合增强CT对肝局灶性结节与小肝细胞癌早期的临床鉴别诊断价值

Clinical Value of Contrast-enhanced Ultrasound Combined with Contrast-enhanced CT in the Early Differential Diagnosis of Focal Nodular Hyperplasia and Small Hepatocellular Carcinoma

目的 探究超声造影(CEUS)联合增强CT(CECT)对肝局灶性结节(FNH)与小肝细胞癌(SHCC)早期的鉴别诊断价值。方法 以2000年3月-2023年3月天津市蓟州区人民医院收治的FNH患者(50例)与早期SHCC患者(32例)为研究对象,依次行CEUS与CECT检查,比较FNH患者与SHCC患者的CEUS参数(开始消退时间、峰值减半时间、下降支斜率)及CECT特征(开始增强时间、增强达峰时间、开始减退时间),统计CEUS、CECT及两者联合检测对两种疾病的检出结果,并分析其鉴别诊断价值(诊断准确性、敏感度与特异度)。结果 在CEUS检查中,FNH患者的开始消退时间、峰值减半时间晚于SHCC患者,下降支斜率小于SHCC患者(P<0.05)。在CECT检查中,FNH患者与SHCC患者开始增强时间比较,差异无统计学意义(P>0.05),但FNH患者的增强达峰时间、开始消退时间晚于SHCC患者(P<0.05)。CEUS联合CECT检测FNH检出率、SHCC检出率高于其单一检测(P<0.05)。CEUS联合CECT检测对FNH与早期SHCC的诊断准确性、敏感度与特异度高于其单一检测(P<0.05)。结论 CEUS、CECT在FNH与SHCC早期鉴别诊断中具有确切作用,二者联合应用诊断价值更佳。

Objective To explore the value of contrast-enhanced ultrasound(CEUS)combined with contrast-enhanced CT(CECT)in the early differential diagnosis of focal nodular hyperplasia(FNH)and small hepatocellular carcinoma(SHCC).Methods From March 2000 to March 2023,50 patients with FNH and 32 patients with early SHCC admitted to the Jizhou District People's Hospital of Tianjin were selected as the research objects.CEUS and CECT were performed in turn.The CEUS parameters(initial regression time,peak halving time,descending branch slope)and CECT features(initial enhancement time,peak enhancement time,initial decline time)of FNH patients and SHCC patients were compared.The detection results of CEUS,CECT and their combined detection for the two diseases were statistically analyzed.The value of differential diagnosis(diagnostic accuracy,sensitivity and specificity)was analyzed.Results In CEUS examination,the initial regression time and peak halving time of FNH patients were later than those of SHCC patients,and descending branch slope was smaller than that of SHCC patients(P<0.05).In CECT examination,there was no significant difference in the initial enhancement time between FNH patients and SHCC patients(P>0.05),but the peak enhancement time and initial decline time in FNH patients were later than those in SHCC patients(P<0.05).The detection rate of FNH and SHCC detected by CEUS combined with CECT was higher than that of single detection(P<0.05).The diagnostic accuracy,sensitivity and specificity of CEUS combined with CECT for FNH and early SHCC were higher than those of single detection(P<0.05).Conclusion CEUS and CECT have a definite role in the early differential diagnosis of FNH and SHCC,and the combined application of the two has better diagnostic value.