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目的探讨超声造影(CEUS)与增强计算机体层扫描(CECT)对肝硬化背景下小肝癌(SHCC)的诊断价值及增强特点。方法选取2012年4月至2014年4月间新疆医科大学第二附属医院感染科住院肝硬化患者198例,分别采用CECT及CEUS诊断。观察两种检测方法对SHCC诊断的敏感度、特异度、正确诊断率和增强特点,评价CEUS对CECT的补充诊断价值。结果 170个SHCC病灶中,CEUS检查发现151个,CECT检查发现132个。CEUS对SHCC诊断的特异度优于CECT(P<0.05),两者诊断的敏感度及正确率比较差异无统计学意义(P>0.05)。CECT和CEUS在SHCC各时期的增强分级比较差异无统计学意义(P>0.05)。CECT漏诊38个SHCC病灶,均经CEUS检出为SHCC,对照病理诊断结果,24个病灶诊断正确。结论 CECT和CEUS对肝硬化背景下SHCC的诊断敏感度、准确度及增强模式相似,均能较好地反映SHCC肿瘤学血供特点,两者联合应用,可提高肝硬化背景下SHCC的诊断准确性。
Objective To investigate the diagnostic value and enhancement characteristics of contrast-enhanced ultrasound (CEUS) and enhanced computed tomography (CECT) on small hepatocellular carcinoma (SHCC) with cirrhosis. Methods A total of 198 inpatients with cirrhosis from April 2012 to April 2014 in Department of Infectious Diseases, Second Affiliated Hospital of Xinjiang Medical University were selected for diagnosis by CECT and CEUS respectively. To observe the sensitivity, specificity, correct diagnosis rate and enhancement characteristics of the two detection methods for the diagnosis of SHCC, and to evaluate the value of CEUS in the supplementary diagnosis of CECT. Results Of the 170 SHCC lesions, 151 were detected by CEUS and 132 by CECT. The specificity of CEUS in diagnosing SHCC was better than that of CECT (P <0.05). The sensitivity and accuracy of CEUS in diagnosing SHCC were not statistically different (P> 0.05). There was no significant difference in enhancement grade between CECT and CEUS at all stages of SHCC (P> 0.05). CECT misdiagnosis of 38 SHCC lesions were detected by the CEUS SHCC, control pathological diagnosis, 24 lesions were correctly diagnosed. Conclusions The diagnostic sensitivity, accuracy and enhancement mode of SHCC in cirrhotic patients are similar both in CECT and CEUS, which can reflect the features of oncology blood supply of SHCC well. The combination of the two can improve the diagnosis of SHCC in cirrhosis Sex.