增强CT与磁共振成像在透明细胞型肝癌诊断中的对比研究

摘要/Abstract

摘要： 目的比较增强CT与磁共振成像(MRI)在透明细胞型肝癌(PCCCL)诊断中的价值。方法选取2020年5月—2022年5月期间苏州市中西医结合医院收治的69例疑似PCCCL患者,患者均行增强CT及MRI检查。分析患者的增强CT与MRI影像学特征,统计增强CT与MRI对PCCCL的检出情况,Kappa一致性分析增强CT与MRI与病理诊断PCCCL的符合情况,比较增强CT与MRI对PCCCL的诊断效能。结果 69例疑似PCCCL患者,经病理诊断,59例为PCCCL患者;增强CT对PCCCL的检出率为62.32%,与MRI的75.36%比较,差异无显著性(P>0.05);增强CT诊断PCCCL的结果与金标准的总符合率为72.88%(43/59),经Kappa一致性分析,Kappa=0.438,P<0.05,增强CT与金标准诊断PCCCL具有良好的一致性;MRI诊断PCCCL的结果与金标准的总符合率为88.14%(52/59),经Kappa一致性分析,Kappa=0.714,P<0.05,MRI与金标准诊断PCCCL具有良好的一致性;MRI诊断PCCCL的结果与金标准的总符合率为88.14%,高于CT平扫的72.88%(χ²=4.374,P=0.036);增强CT、MRI 的约登指数分别为0.145,0.414,MRI对PCCCL诊断的灵敏度高于增强CT,漏诊率低于增强CT(P<0.05)。结论增强CT与MRI对于PCCCL诊断均有一定的参考价值,其中MRI对PCCCL诊断具有更高的灵敏度,可以减少漏诊的发生。

关键词: 增强CT, 磁共振成像, 透明细胞型肝癌, 诊断

Abstract: Objective To compare enhanced CT and magnetic resonance imaging (MRI) in the diagnosis of primary clear cell carcinoma in liver (PCCCL). Methods A total of 69 suspected PCCCL patients admitted to Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from May 2020 to May 2022 were selected. All patients underwent enhanced CT and MRI examinations. The imaging features of enhanced CT and MRI were analyzed, and the detection efficacies of PCCCL by enhanced CT and MRI was compared by Kappa consistency analysis based on the pathological diagnosis of PCCCL. Results Among 69 suspected PCCCL patients, 59 were confirmed to have PCCCL after pathological diagnosis. The detection rate of enhanced CT for PCCCL was 62.32%, which hadn’t significant difference when compared with that of 75.36% by MRI (P>0.05). The total coincidence rate of enhanced CT in the diagnosis of PCCCL was 72.88% (43/59). After Kappa consistency analysis, the detection rate of enhanced CT had a good consistency with the pathological gold standard for the diagnosis of PCCCL (Kappa=0.438, P<0.05). The total coincidence rate of MRI diagnosis for PCCCLwas 88.14% (52/59), also shown good consistency with the pathological diagnosis (Kappa=0.714, P<0.05). The coincidence rate between MRI and gold standard in the diagnosis of PCCCL was 88.14%, which was higher than that of CT plain scan (72.88%) (χ²=4.374, P=0.036). The Yoden index of enhanced CT and MRI were 0.145 and 0.414, respectively. The sensitivity of MRI for the diagnosis of PCCCL was higher than that of enhanced CT, and the rate of misdiagnosis was lower than that of enhanced CT (P<0.05). Conclusion Both enhanced CT and MRI have certain reference value for the diagnosis of PCCCL, among which MRI has higher sensitivity and may reduce the occurrence of misdiagnosis.

Key words: Enhanced CT, Magnetic resonance imaging, Primary clear cell carcinoma of the liver, Diagnosis

叶颖, 杨娇, 吴士臣. 增强CT与磁共振成像在透明细胞型肝癌诊断中的对比研究[J]. 肝脏, 2023, 28(10): 1179-1181.

YE Ying, YANG Jiao, WU Shi-chen. Comparative study of enhanced CT and magnetic resonance imaging in the diagnosis of primary clear cell carcinoma in liver[J]. Chinese Hepatolgy, 2023, 28(10): 1179-1181.

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