螺旋CT平扫及其三期动态增强扫描检查诊断肝癌的价值①
张东青 林立夫 欧春燕 陈俏倩 余佐时
广东医科大学附属第二医院
摘要：目的：探讨螺旋CT平扫及其三期动态增强扫描检查诊断肝癌的临床应用价值。方法：选取86例疑似肝癌患者，分别采用螺旋CT平扫及其三期动态增强扫描检查。以手术病理学检查为金标准，分析螺旋CT平扫及其三期动态增强扫描检查诊断肝癌的应用价值及两种检查与手术病理学检查的一致性。结果：手术病理学检查86例疑似肝癌患者，48例为肝癌，38例为良性病变；三期动态增强扫描检查肝癌的灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于CT平扫检查，差异有统计学意义（P＜0.05）;CT平扫检查与手术病理学检查的一致性较低（Kappa=0.365）,三期动态增强扫描检查与手术病理学检查的一致性较高（Kappa=0.882）。结论：CT三期动态增强扫描检查诊断肝癌的价值高于常规CT平扫。
关键词：肝癌;螺旋CT平扫;螺旋CT三期动态增强扫描;
Values of spiral CT plain scanning and triphasic dynamic-enhanced scanning in the diagnosis of hepatocellular carcinoma①
ZHANG Dongqing②,LIN Lifu,OU Chunyan,CHEN Qiaoqian,YU Zuoshi.(The 2nd Affiliated Hospital of Guangdong Medical University,Zhanjiang 524003,China)
Abstract Objective: To investigate the clinical application values of spiral CT plain scanning and triphasic dynamic-enhanced scanning in the diagnosis of patients with hepatocellular carcinoma (HCC). Methods: 86 cases of suspected hepatocellular carcinoma patients were selected and scanned by spiral CT plain scanning and triphasic dynamic-enhanced scanning, respectively. Surgical pathological examination was used as the gold standard, this paper analyzed the different application values of spiral CT plain scanning and triphasic dynamic-enhanced scanning in the diagnosis of patients with hepatocellular carcinoma, and the consistency between the two examination and their surgical pathological examination results. Results: Pathological examination of 86 patients with suspected HCC showed that 48 patients were with HCC and 38 patients were with benign lesions. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of phase III dynamic-enhanced scanning for liver cancer were higher than that of plain CT scanning, and the difference was statistically significant (P<0.05); The consistency between CT plain scanning and surgical pathological examination was lower(Kappa=0.365), and the consistency between triphasic dynamic-enhanced scanning and surgical pathological examination was higher(Kappa=0.882). Conclusion: The diagnostic value of triphasic dynamic-enhanced scanning is higher than that of conventional CT plain scanning.
Keywords: hepatocellular carcinoma (HCC); spiral CT plain scanning; spiral CT triphasic dynamicenhanced scanning
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