超声联合MSCT诊断早期肝癌的临床研究
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摘要
目的探究超声联合多排螺旋CT(MSCT)对早期肝癌诊断的临床价值。方法回顾性分析80例早期肝癌患者临床资料,以细针穿刺活检术或数字血管减影造影术(DSA)检查结果为"金标准",分析超声、MSCT及联合检查对病变特征[假包膜、肝内动静脉瘘(AVF)、门静脉癌栓(PVTT)]诊断效果差异。结果联合检查诊断假包膜、PVTT准确度均明显高于单纯超声、MSCT检查,诊断AVF准确度则明显高于单纯超声检查,差异均有统计学意义(P<0.05);联合检查在诊断病变特征方面与对应"金标准"一致性均属良好(κ>0.70)。结论超声联合MSCT应用于早期肝癌诊断中可获取较多病变特征信息,临床应用价值较高。
Objective To explore the clinical value of ultrasound combined with multislice spiral CT(MSCT) in the diagnosis of early liver cancer. Methods The clinical data of80 patients with early liver cancer were retrospectively analyzed. The results of fine needle aspiration biopsy or digital subtraction angiography(DSA) were used as gold standard to analyze the diagnostic effects of ultrasound, MSCT and combined examination on the lesion features [pseudocapsule, arterio-venous fistula(AVF), portal vein tumor thrombus(PVTT)]. Results The accuracies of combined diagnosis in the diagnosis of pseudocapsule and PVTT were significantly higher than those of simple ultrasound and MSCT, and the accuracy in the diagnosis of AVF was significantly higher than that of simple ultrasound(P<0.05). The consistency of combined diagnosis in the diagnosis of lesion features was good with corresponding gold standard(κ>0.70). Conclusion Ultrasound combined with MSCT can obtain more lesion features in the diagnosis of early liver cancer, and it has high clinical application value.
Objective To explore the clinical value of ultrasound combined with multislice spiral CT(MSCT) in the diagnosis of early liver cancer. Methods The clinical data of80 patients with early liver cancer were retrospectively analyzed. The results of fine needle aspiration biopsy or digital subtraction angiography(DSA) were used as gold standard to analyze the diagnostic effects of ultrasound, MSCT and combined examination on the lesion features [pseudocapsule, arterio-venous fistula(AVF), portal vein tumor thrombus(PVTT)]. Results The accuracies of combined diagnosis in the diagnosis of pseudocapsule and PVTT were significantly higher than those of simple ultrasound and MSCT, and the accuracy in the diagnosis of AVF was significantly higher than that of simple ultrasound(P<0.05). The consistency of combined diagnosis in the diagnosis of lesion features was good with corresponding gold standard(κ>0.70). Conclusion Ultrasound combined with MSCT can obtain more lesion features in the diagnosis of early liver cancer, and it has high clinical application value.
引文
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[3]郭新忠,戚元刚.超声和CT鉴别诊断肝硬化再生结节和小肝癌的价值分析[J].现代消化及介入诊疗,2015,20(2):140-142.
[4]符圣兴,蔡亲磊,陈正华.超声和双层螺旋CT早期诊断及鉴别小肝癌患者结果比较[J].中国实验诊断学,2016,20(4):640-641.
[5]王胜裕,蒯新平,王鹏,等.CT对肝血管平滑肌脂肪瘤与肝细胞肝癌的鉴别诊断价值[J].中国医学影像学杂志,2013,21(12):924-927
[6]李友炳,杨静,张军,等.原发性肝癌肿瘤直径和假包膜与经动脉化学栓塞术疗效的关系[J].肿瘤,2014,34(8):734-738.
[7]纪建松,杨宏远,王祖飞,等.超声、CT及MRI随访在肝硬化结节恶变筛查及诊断中的价值[J].中华医学杂志,2014,94(5):368-371.
[8]陈立军,杨仁杰,朱林忠,等.原发性肝癌介入术中肝动脉-门静脉瘘的影像学特点及治疗[J].中国肿瘤临床,2015,42(11):570-575.
[9]杨洋,郭武华.肝细胞癌合并动-门静脉瘘的诊治进展[J].临床肝胆病杂志,2017,33(2):364-368.
[10]张文君,陈燕,潘勐.原发性肝癌合并癌栓的研究进展[J].中国普通外科杂志,2015,24(7):1017-1021.
[11]吴孟超,汤钊猷,刘允怡,等.肝细胞癌合并门静脉癌栓多学科诊治中国专家共识(2016年版)[J].消化肿瘤杂志(电子版), 2 0 1 6,15(3):411-416.
[12]周赵霞,俞高龙,徐贤,等.320排CT及血管成像在肝癌诊断及介入治疗中的优势[J].实用放射学杂志,2016,32(2):274-276.
[2]司同,黄爱娜,王燕飞.108例肝癌患者超声及腹部CT扫描特点及诊断价值分析[J].中国CT和MRI杂志,2016,14(12):77-79.
[3]郭新忠,戚元刚.超声和CT鉴别诊断肝硬化再生结节和小肝癌的价值分析[J].现代消化及介入诊疗,2015,20(2):140-142.
[4]符圣兴,蔡亲磊,陈正华.超声和双层螺旋CT早期诊断及鉴别小肝癌患者结果比较[J].中国实验诊断学,2016,20(4):640-641.
[5]王胜裕,蒯新平,王鹏,等.CT对肝血管平滑肌脂肪瘤与肝细胞肝癌的鉴别诊断价值[J].中国医学影像学杂志,2013,21(12):924-927
[6]李友炳,杨静,张军,等.原发性肝癌肿瘤直径和假包膜与经动脉化学栓塞术疗效的关系[J].肿瘤,2014,34(8):734-738.
[7]纪建松,杨宏远,王祖飞,等.超声、CT及MRI随访在肝硬化结节恶变筛查及诊断中的价值[J].中华医学杂志,2014,94(5):368-371.
[8]陈立军,杨仁杰,朱林忠,等.原发性肝癌介入术中肝动脉-门静脉瘘的影像学特点及治疗[J].中国肿瘤临床,2015,42(11):570-575.
[9]杨洋,郭武华.肝细胞癌合并动-门静脉瘘的诊治进展[J].临床肝胆病杂志,2017,33(2):364-368.
[10]张文君,陈燕,潘勐.原发性肝癌合并癌栓的研究进展[J].中国普通外科杂志,2015,24(7):1017-1021.
[11]吴孟超,汤钊猷,刘允怡,等.肝细胞癌合并门静脉癌栓多学科诊治中国专家共识(2016年版)[J].消化肿瘤杂志(电子版), 2 0 1 6,15(3):411-416.
[12]周赵霞,俞高龙,徐贤,等.320排CT及血管成像在肝癌诊断及介入治疗中的优势[J].实用放射学杂志,2016,32(2):274-276.
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