多层螺旋CT在原发性肝癌患者TACE术后随访中的应用
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摘要
目的分析多层螺旋CT(MSCT)在原发性肝癌患者经肝动脉化疗栓塞(TACE)术后随访中的应用。方法选择我院2013年1月至2017年12月确诊为原发性肝癌并行TACE术的84例患者,术后定期进行MSCT扫描,记录肿瘤残留率、肝内肿瘤复发率及新生病灶检出率。结果 MSCT检查肿瘤残留灵敏度、特异度和准确率分别为85.29%、91.46%和89.66%。MSCT检查肝内肿瘤复发灵敏度、特异度和准确率分别为93.10%、94.25%和93.97%。MSCT新生病灶检出率为74.07%,漏诊率为14.81%,误诊率为11.11%。结论 MSCT对原发性肝癌患者TACE术后肿瘤残留、肝内肿瘤复发检出均有较高诊断价值。
Objective To analyze the application of multislice spiral CT(MSCT) in the follow-up of patients with primary liver cancer after transhepatic arterial chemoembolization(TACE). Methods 84 cases of patients diagnosed as primary liver cancer and treated with TACE from January 2013 and December 2017 in our hospital were selected, and they were given the MSCT scan regularly after operation. The tumor residual rate, recurrence rate of intrahepatic tumor and the detection rate of new lesions were recorded. Results The sensitivity, specificity and accuracy of MSCT in diagnosis of tumor residual were 85.29%, 91.46% and 89.66%. And the sensitivity, specificity and accuracy of MSCT in detecting intrahepatic tumor recurrence were 93.10%, 94.25% and 93.97%. The detection rate of new lesions by MSCT was 74.07%, and the missed diagnosis rate was 14.81%, and the misdiagnosis rate was 11.11%. Conclusion MSCT is of high diagnostic value for the detection of tumor residual and intrahepatic tumor recurrence after TACE operation in patients with primary liver cancer.
Objective To analyze the application of multislice spiral CT(MSCT) in the follow-up of patients with primary liver cancer after transhepatic arterial chemoembolization(TACE). Methods 84 cases of patients diagnosed as primary liver cancer and treated with TACE from January 2013 and December 2017 in our hospital were selected, and they were given the MSCT scan regularly after operation. The tumor residual rate, recurrence rate of intrahepatic tumor and the detection rate of new lesions were recorded. Results The sensitivity, specificity and accuracy of MSCT in diagnosis of tumor residual were 85.29%, 91.46% and 89.66%. And the sensitivity, specificity and accuracy of MSCT in detecting intrahepatic tumor recurrence were 93.10%, 94.25% and 93.97%. The detection rate of new lesions by MSCT was 74.07%, and the missed diagnosis rate was 14.81%, and the misdiagnosis rate was 11.11%. Conclusion MSCT is of high diagnostic value for the detection of tumor residual and intrahepatic tumor recurrence after TACE operation in patients with primary liver cancer.
引文
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[10]杨乃忠,董从松,刘洋,等.MRI对原发性肝癌患者TACE术后肿瘤残余或复发病灶显示效果的评价[J].肝脏,2016,21(11):951-953.
[11]李智勇,景永生,齐东海.多层螺旋CT三维成像技术对隐匿性肋骨骨折的诊断价值[J].陕西医学杂志,2015,44(6):702-704.
[12]杨强帮,戎祯祥,张浩,等.腹腔镜右半结肠癌D3根治术的术前MSCT三维重建观测指标的探讨[J].广东医学,2016,37(18):2757-2759.
[13]项昆,赵鹤亮,郑昌英,等.16排螺旋CT和MRI对原发性肝癌TACE术后病灶的疗效判断价值对比[J].实用癌症杂志,2014,29(10):1315-1321.
[14]杨敏玲,杨志勇,谢春明.原发性肝癌TACE术后残留及新发病灶的CT和DSA诊断对比研究[J].肿瘤研究与临床,2014,26(3):145-152.
[15]黄卫民,徐辉,汪继辉.CT增强扫描和DSA检测原发性肝癌TACE术后肿瘤残留及新发病灶[J].中国CT和MRI杂志,2016,14(9):77-79.
[2]张宁宁,陆伟.原发性肝癌非手术治疗的现状与展望[J].实用肿瘤杂志,2014,29(4):302-308.
[3]黄佩新,乐凡,赵志英,等.肝动脉化疗栓塞术后股动脉假性动脉瘤发生的影响因素[J].肿瘤,2016,36(7):765-771.
[4]武中林,吴勇超,杨超,等.原发性肝癌经导管肝动脉化疗栓塞术后应用不同保肝方案的效果比较研究[J].中国全科医学,2017,20(23):2862-2867.
[5]李爽,吕维富,董金斌,等.肝细胞癌化疗栓塞术后MSCT与MRI随访的对比分析[J].安徽医科大学学报,2014,49(3):389-391.
[6]蒋凤,雷宇,钟珊,等.577例原发性肝癌患者临床特征和治疗方案选择分析[J].实用肝脏病杂志,2014,17(3):237-240.
[7]何川东,周莹,黄丹,等.宝石CT能谱成像在肝癌经皮肝动脉化疗栓塞术后疗效评估及随访中的应用价值[J].介入放射学杂志,2016,25(1):34-39.
[8]敖劲,曾令雯,刘衡,等.原发性肝癌DSA表现与TACE疗效的关系分析[J].中国普通外科杂志,2016,25(1):51-56.
[9]闫景伟.MSCT与MRI对肝细胞肝癌T A C E术后疗效评价的价值分析[J].临床和实验医学杂志,2014,13(15):1303-1304.
[10]杨乃忠,董从松,刘洋,等.MRI对原发性肝癌患者TACE术后肿瘤残余或复发病灶显示效果的评价[J].肝脏,2016,21(11):951-953.
[11]李智勇,景永生,齐东海.多层螺旋CT三维成像技术对隐匿性肋骨骨折的诊断价值[J].陕西医学杂志,2015,44(6):702-704.
[12]杨强帮,戎祯祥,张浩,等.腹腔镜右半结肠癌D3根治术的术前MSCT三维重建观测指标的探讨[J].广东医学,2016,37(18):2757-2759.
[13]项昆,赵鹤亮,郑昌英,等.16排螺旋CT和MRI对原发性肝癌TACE术后病灶的疗效判断价值对比[J].实用癌症杂志,2014,29(10):1315-1321.
[14]杨敏玲,杨志勇,谢春明.原发性肝癌TACE术后残留及新发病灶的CT和DSA诊断对比研究[J].肿瘤研究与临床,2014,26(3):145-152.
[15]黄卫民,徐辉,汪继辉.CT增强扫描和DSA检测原发性肝癌TACE术后肿瘤残留及新发病灶[J].中国CT和MRI杂志,2016,14(9):77-79.