MRI及MSCT用于肝内胆管细胞癌临床诊断的效能分析

摘要/Abstract

摘要： 目的分析磁共振成像(MRI)和多层螺旋计算机断层扫描(MSCT)对肝内胆管细胞癌(ICC)的诊断价值。方法 2017年3月至2022年3月徐州医科大学附属医院收治的原发性肝癌患者70例,患者均接受MRI和MSCT检查,以手术后组织病理学检查和穿刺活检为金标准,MRI、MSCT联合诊断时任意一种方法诊断为ICC即判定为ICC,评估MRI和MSCT单独及联合诊断ICC的效能。结果病理诊断结果显示70例原发性肝癌患者中23例为ICC、47例为肝细胞癌(HCC)。MRI诊断结果显示,70例原发性肝癌中20例为ICC、50例为HCC。MRI诊断ICC的敏感度为69.6%、特异度为91.5%、准确率为84.3%、Kappa值为0.632。MSCT诊断结果显示,70例原发性肝癌中22例为ICC、48例为HCC。MSCT诊断ICC的敏感度为65.2%、特异度为85.1%、准确率为78.6%、Kappa值为0.509。MRI联合MSCT诊断结果显示,70例原发性肝癌中21例为ICC、49例为HCC。MRI联合MSCT诊断ICC的敏感度为82.6%、特异度为95.7%、准确率为91.4%、Kappa值为0.801。MRI、MSCT诊断ICC的准确率分别为59例(84.3%)、54例(78.6%),差异无统计学意义(P>0.05),MRI联合MSCT诊断的准确率67例(95.7%)明显高于MRI、MSCT单独诊断(P<0.05)。结论 MRI、MSCT用于诊断ICC准确率均较高,与病理诊断结果具有较好的一致性,二者联合诊断可提高诊断价值。

关键词: 肝内胆管细胞癌, 肝细胞癌, 磁共振成像, 多层螺旋计算机断层扫描, 诊断

Abstract: Objective Analyze the diagnostic value of magnetic resonance imaging (MRI) and multi-slice spiral computed tomography (MSCT) in detecting intrahepatic cholangiocarcinoma (ICC).Methods A total of 70 patients with primary liver cancer were admitted to our hospital between March 2017 and March 2022. All patients underwent MRI and MSCT examinations. The gold standard for diagnosis was postoperative histopathology examination and biopsy. If either MRI or MSCT diagnosed the patient with ICC, it was considered as ICC. We evaluated the efficacy of MRI, MSCT, and the combination of both in diagnosing ICC.Results Pathological diagnosis showed that out of the 70 patients with primary liver cancer, 23 were diagnosed with ICC and 47 with hepatocellular carcinoma (HCC).The MRI results identified 20 cases of ICC and 50 cases of HCC among the 70 cases of primary liver cancer. The sensitivity, specificity, accuracy, and Kappa value of MRI in diagnosing ICC were 69.6%, 91.5%, 84.3%, and 0.632, respectively. The MSCT identified 22 cases of ICC and 48 cases of HCC among the 70 cases of primary liver cancer. The sensitivity, specificity, accuracy, and Kappa value of MSCT in diagnosing ICC were 65.2%, 85.1%, 78.6%, and 0.509, respectively. The combined diagnostic results of MRI and MSCT showed that 21 cases were ICC and 49 cases were HCC among the 70 cases of primary liver cancer. The sensitivity, specificity, accuracy, and Kappa value of MRI combined with MSCT in diagnosing ICC were 82.6%, 95.7%, 91.4%, and 0.801, respectively. The accuracy of MRI and MSCT in diagnosing ICC was 59 cases (84.3%) and 54 cases (78.6%), respectively, with no statistically significant difference (P>0.05). However, the accuracy of MRI combined with MSCT in diagnosing ICC was significantly higher, with 67 cases (95.7%) (P<0.05).Conclusion MRI and MSCT are highly accurate in diagnosing ICC and show good consistency with pathological diagnosis. Furthermore, the combination of these two methods enhances the diagnostic value even further.

Key words: Intrahepatic cholangiocarcinoma, Hepatocellular carcinoma, Magnetic resonance imaging, Multi layer spiral computed tomography, diagnosis

程丽, 李江山, 孙小伶. MRI及MSCT用于肝内胆管细胞癌临床诊断的效能分析[J]. 肝脏, 2023, 28(11): 1314-1318.

CHENG Li, LI Jiang-shan, SUN Xiao-ling. Analysis of the efficacy of MRI and MSCT in the clinical diagnosis of intrahepatic cholangiocarcinoma[J]. Chinese Hepatolgy, 2023, 28(11): 1314-1318.

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