CT扫描对肝占位病变的鉴别诊断效果探讨(1)
摘要：目的 分析CT扫描在肝占位病变中的鉴别诊断效果。方法 选取我院收治的73例肝占位病变患者，纳入时间为2015年6月至2017年6月。分别进行CT平扫、增强扫描、超声造影检查，对比临床诊断结果。结果 以病理诊断为金标准，CT平掃诊断肝占位病变的灵敏度为63.1%、特异性为71.4%、准确率为67.1%;CT增强扫描的灵敏度为94.7%、特异性为97.1%、准确率为95.9%，对比差异明显(P<0.05)。在各类病灶的分布上，CT增强扫描和超声造影的检出率对比差异不大(P>0.05)。和良性病变相比，恶性病变的达峰时间、上升时间短，灌注指数低，差异显著(P<0.05)。结论 CT增强扫描鉴别诊断肝占位病变的准确率高，和超声造影检查结果相当，可以作为临床治疗和预后评估的依据。
关键词：肝占位病变;CT扫描;超声造影;准确性
中图分类号：R816 文献标识码：A 文章编号：1672-3783(2018)01-0003-03
Abstract：Objective to analyze the differential diagnosis effect of CT scan in liver occupying lesions. Methods 73 cases of liver occupying lesions admitted in our hospital were selected from June 2015 to June 2017. CT plain scan， enhanced scan and contrast-enhanced ultrasound were performed respectively， and the clinical diagnosis results were compared. Results with the pathological diagnosis as gold standard， the sensitivity of CT scan in the diagnosis of hepatic space occupying lesions was 63.1%， the specificity was 71.4%， the accuracy was 67.1%， the sensitivity of CT enhanced scan was 94.7%， the specificity was 97.1%， the accuracy was 95.9%， and the contrast difference was obvious (P < 0.05). There was no significant difference in the detection rate of all kinds of lesions between CT enhanced ultrasound and contrast-enhanced ultrasound (P > 0.05). Compared with benign lesions， the peak time， the rising time and the perfusion index of malignant lesions were low， and the difference was significant (P < 0.05). Conclusion the accuracy of CT enhanced scan in the differential diagnosis of hepatic space occupying lesions is high， which is equivalent to the results of ultrasound contrast examination， which can be used as a basis for clinical treatment and prognosis evaluation.
Key words：liver occupying lesion; CT scan; contrast enhanced ultrasound; accuracy.
肝占位病变指的是肝脏内出现局灶性病变，包括良性和恶性两种类型，以肝癌、肝血管瘤、结节增生比较常见。考虑到该类疾病的种类复杂，提高诊断的及时性和准确性，有利于制定个性化的治疗方案，继而改善患者预后[1]。目前影像学检查以CT、MRI、超声等为主，且不同检查方法各具优缺点，为了进一步探讨CT扫描的临床应用价值，本文对我院73例患者进行研究，对比了CT平扫、增强扫描、超声造影的诊断结果，报告如下：
1 资料与方法
1.1 一般资料
选取我院收治的肝占位病变患者73例，时间段为2015年6月至2017年6月。包括男性40例(54.8%)，女性33例(45.2%);年龄位于28-76岁，平均(46.3±7.7)岁;病程6个月-5年，平均(2.3±0.8)年。病理检查结果：恶性病变38例，均为肝细胞癌;良性病变35例，包括肝囊肿5例、肝腺瘤3例、肝血管瘤17例、结节增生10例。病灶直径最小0.5cm、最大11cm，平均(5.8±1.4)cm。
1.2 纳入和排除标准
依据《新编实用肝脏病学》[2]，纳入标准：(1)患者年龄18-80岁，临床资料完整;(2)经病理学检查确诊，且病灶均为单发;(3)签署知情同意书。排除标准：(1)排除精神病史患者;(2)排除造影剂过敏患者;(3)排除心肝肾功能不全患者;(4)排除其他部位恶性肿瘤患者。
1.3 方法
1.3.1 CT诊断, 百拇医药(郭奎)
关键词：肝占位病变;CT扫描;超声造影;准确性
中图分类号：R816 文献标识码：A 文章编号：1672-3783(2018)01-0003-03
Abstract：Objective to analyze the differential diagnosis effect of CT scan in liver occupying lesions. Methods 73 cases of liver occupying lesions admitted in our hospital were selected from June 2015 to June 2017. CT plain scan， enhanced scan and contrast-enhanced ultrasound were performed respectively， and the clinical diagnosis results were compared. Results with the pathological diagnosis as gold standard， the sensitivity of CT scan in the diagnosis of hepatic space occupying lesions was 63.1%， the specificity was 71.4%， the accuracy was 67.1%， the sensitivity of CT enhanced scan was 94.7%， the specificity was 97.1%， the accuracy was 95.9%， and the contrast difference was obvious (P < 0.05). There was no significant difference in the detection rate of all kinds of lesions between CT enhanced ultrasound and contrast-enhanced ultrasound (P > 0.05). Compared with benign lesions， the peak time， the rising time and the perfusion index of malignant lesions were low， and the difference was significant (P < 0.05). Conclusion the accuracy of CT enhanced scan in the differential diagnosis of hepatic space occupying lesions is high， which is equivalent to the results of ultrasound contrast examination， which can be used as a basis for clinical treatment and prognosis evaluation.
Key words：liver occupying lesion; CT scan; contrast enhanced ultrasound; accuracy.
肝占位病变指的是肝脏内出现局灶性病变，包括良性和恶性两种类型，以肝癌、肝血管瘤、结节增生比较常见。考虑到该类疾病的种类复杂，提高诊断的及时性和准确性，有利于制定个性化的治疗方案，继而改善患者预后[1]。目前影像学检查以CT、MRI、超声等为主，且不同检查方法各具优缺点，为了进一步探讨CT扫描的临床应用价值，本文对我院73例患者进行研究，对比了CT平扫、增强扫描、超声造影的诊断结果，报告如下：
1 资料与方法
1.1 一般资料
选取我院收治的肝占位病变患者73例，时间段为2015年6月至2017年6月。包括男性40例(54.8%)，女性33例(45.2%);年龄位于28-76岁，平均(46.3±7.7)岁;病程6个月-5年，平均(2.3±0.8)年。病理检查结果：恶性病变38例，均为肝细胞癌;良性病变35例，包括肝囊肿5例、肝腺瘤3例、肝血管瘤17例、结节增生10例。病灶直径最小0.5cm、最大11cm，平均(5.8±1.4)cm。
1.2 纳入和排除标准
依据《新编实用肝脏病学》[2]，纳入标准：(1)患者年龄18-80岁，临床资料完整;(2)经病理学检查确诊，且病灶均为单发;(3)签署知情同意书。排除标准：(1)排除精神病史患者;(2)排除造影剂过敏患者;(3)排除心肝肾功能不全患者;(4)排除其他部位恶性肿瘤患者。
1.3 方法
1.3.1 CT诊断, 百拇医药(郭奎)
参见：首页 > 中医药 > 中药专业 > 中药鉴别