CT动态增强扫描诊断原发性肝癌效能分析*

doi:10.3969/j.issn.1672-5069.2024.06.030

实用肝脏病杂志 ›› 2024, Vol. 27 ›› Issue (6): 919-922.doi: 10.3969/j.issn.1672-5069.2024.06.030

CT动态增强扫描诊断原发性肝癌效能分析^*

邓娜, 郑玉凤, 刘旭红, 韩晓兵, 丁碧娇, 曾纬阳, 刘娜红, 黄莹, 陈梅桂

362000 福建省泉州市解放军联勤保障部队第九一○医院医学影像科(邓娜,郑玉凤,刘旭红,韩晓兵,丁碧娇,曾纬阳,刘娜红,黄莹);福建医科大学附属第二医院CT室( 陈梅桂)

收稿日期:2024-04-25 出版日期:2024-11-10 发布日期:2024-11-07
通讯作者: 黄莹,E-mail:huangyingct@aliyun.com
作者简介:邓娜,女,35岁,大学本科,住院医师。E-mail:15060878318@163.com
基金资助:
^*福建省泉州市科技发展计划项目(编号:2021C056R)

Diagnostic efficacy of CT dynamic enhancement scan in patients with liver cirrhosis and intrahepatic space-occupying lesions

Deng Na, Zheng Yufeng, Liu Xuhong, et al

Department of Radiology, 910th Hospital, Joint Logistic Support Force, Quanzhou 362000, Fujian Province,China

Received:2024-04-25 Online:2024-11-10 Published:2024-11-07

摘要/Abstract

摘要： 目的探讨CT动态增强扫描对肝硬化合并原发性肝癌(PLC)的诊断效能。方法 2018年2月～2023年5月我院诊治的120例肝硬化合并肝内结节患者,均接受CT动态增强扫描,经细针穿刺或手术后组织病理学检查结果为“金标准”,评判CT动态增强扫描诊断的效能。结果组织病理学检查诊断肝细胞癌(HCC)84例(70.0%),诊断肝内局灶性增生性结节(FPN)36例(30.0%);HCC病灶动脉期呈高增强为100.0%,门脉期呈等增强为56.0%,延迟期呈低增强为97.6%,而FPN病灶动脉期、门脉期和延迟期呈等增强者分别为88.9%、94.4%和100.0%; 在120例肝硬化合并肝内结节患者中,CT动态增强扫描诊断PLC者83例(69.2%),FPN者37例(30.8%),与病理学诊断结果的Kappa值为0.902,诊断的敏感度、特异度、准确度、阴性预测值和阳性预测值分别为96.4%、94.4%、95.8%、91.9%和97.6%。结论 CT动态增强扫描可以通过各期表现特点准确诊断肝硬化合并PLC病灶,具有很大的临床应用价值。

关键词: 原发性肝癌, 肝硬化, CT动态增强扫描, 诊断

Abstract: Objective The aim of this study was to investigate diagnostic efficacy of CT dynamic enhancement scan in patients with liver cirrhosis and intrahepatic space-occupying lesions (SOL). Methods 120 patients with intrahepatic SOL were encountered in our hospital between February 2018 and May 2023, and all underwent CT dynamic enhancement scan. Golden diagnosis was based on histo-pathological examination by fine needle aspiration biopsies or post-operational tissues. Results Pathological diagnosis included hepatocellular carcinoma (HCC) in 84 cases (70.0%)and focal proliferative nodules (FPN) in 36 cases(30.0%) in our series; in lesions of HCC, percentage of intensified enhancement at arterial phase was 100.0%, equal enhancement at portal phase was 56.0% and low enhancement at delayed phase was 97.6%, while in lesions of FPN, the percentages of equal enhancement at arterial, portal and delayed phases were 88.9%, 94.4% and 100.0%; of the 120 cirrhotics with intrahepatic SOL, CT scan diagnosed primary liver cancer in 83 cases (69.2%) and FPN in 37 cases (30.8%), with sensitivity, specificity, accuracy, negative predictive value and positive predictive value of 96.4%, 94.4%, 95.8%, 91.9% and 97.6%, respectively (Kappa=0.902). Conclusion The feature of intrahepatic SOL showing by CT dynamic enhancement scan at different phases could help clinicians make a correct diagnosis, and deal with it appropriately.

Key words: Hepatoma, Liver cirrhosis, Focal proliferative nodules, CT dynamic enhancement scan, Diagnosis

邓娜, 郑玉凤, 刘旭红, 韩晓兵, 丁碧娇, 曾纬阳, 刘娜红, 黄莹, 陈梅桂. CT动态增强扫描诊断原发性肝癌效能分析^*[J]. 实用肝脏病杂志, 2024, 27(6): 919-922.

Deng Na, Zheng Yufeng, Liu Xuhong, et al. Diagnostic efficacy of CT dynamic enhancement scan in patients with liver cirrhosis and intrahepatic space-occupying lesions[J]. Journal of Practical Hepatology, 2024, 27(6): 919-922.

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CT动态增强扫描诊断原发性肝癌效能分析^*

Diagnostic efficacy of CT dynamic enhancement scan in patients with liver cirrhosis and intrahepatic space-occupying lesions

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