摘要
目的探索CT、MRI及联合诊断用于肝癌或肝脏局灶性结节增生患者的诊断效能。方法上海市市东医院2020年3月—2023年3月收治的153例疑似原发性肝癌患者作为研究对象。患者入院后均完成CT、MRI扫描及病理学检查,且以病理学检查结果为金标准,所有患者均确诊为肝癌或肝脏局灶性结节增生。比较两种方法单独检查及联合检查的灵敏度、特异度、准确率、阳性预测值、阴性预测值、一致性。结果所有患者均完成穿刺病理活检或术中/术后病理学检查,最终确诊肝癌患者有61例,肝脏局灶性结节增生患者92例。所有患者经手术或腹腔镜检查对病灶进行确定,61例原发性肝癌患者共有病灶93处,直径0.45~12.00cm,超过3cm病灶34处,1~3cm病灶42处,小于1cm病灶17处,平均直径(5.15±1.84)cm。其中CT、MRI及联合检查分别发现病灶83(89.25%)处、85(91.40%)处和91(97.85%)处。联合检查的检出率明显高于两种方法单独检查,差异有统计学意义(P<0.05)。联合扫描的灵敏度、特异度、准确率、阳性预测值、阴性预测值、一致性分别为95.08%,85.87%,80.95%,81.69%,96.34%,89.54%,均明显高于CT、MRI单独扫描,差异均有统计学意义(P<0.05)。结论肝癌或肝脏局灶性结节增生采用CT、MRI联合诊断的诊断效能更高,值得推广应用于早期肝癌的诊断或筛检。
Objective To explore the diagnostic efficacy of CT,MRI,and combined diagnosis in patients with liver cancer or focal nodular hyperplasia.Methods We studied 153 suspected primary liver cancer patients admitted to Shanghai Shidong Hospital from March 2020 to March 2023.After admission,all patients completed CT,MRI scans,and pathological examinations,and based on the pathological examination results as the gold standard,all patients were diagnosed with liver cancer or focal nodular hyperplasia of the liver.Compare the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and consistency of two methods for individual and combined examinations.Results All patients completed puncture pathological biopsy or intraoperative/postoperative pathological examination,and 61 patients were ultimately diagnosed with liver cancer and 92 patients with focal nodular hyperplasia of the liver.All patients underwent surgery or laparoscopic examination to determine the lesions.Among the 61 patients with primary liver cancer,there were a total of 93 lesions with a diameter of 0.45~12.00cm,34 lesions exceeding 3cm,42 lesions 1~3cm,and 17 lesions less than 1cm,with an average diameter of(5.15±1.84)cm.CT,MRI,and combined examination revealed 83(89.25%),85(91.40%),and 91(97.85%)lesions,respectively.The detection rate of joint examination was significantly higher than that of the two separate methods,and the difference was statistically significant(P<0.05).The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and consistency of combined scans were 95.08%,85.87%,80.95%,81.69%,96.34%,and 89.54%,respectively,which were significantly higher than those of CT and MRI scans alone,with statistical significance(all P<0.05).Conclusion The diagnostic efficacy of combining CT and MRI for liver cancer or focal nodular hyperplasia in the liver is higher,and it is worth promoting and applying to the diagnosis or screening of early liver cancer.
作者
曹爽
徐长青
Cao Shuang;Xu Changqing(Department of Medical Imaging,Shanghai Shidong Hospital,Shanghai 200438,China)
出处
《现代仪器与医疗》
CAS
2023年第5期77-80,共4页
Modern Instruments & Medical Treatment
关键词
原发性肝癌
病理
灵敏度
筛检
Primary liver cancer
Pathology
Sensitivity
Screening
