摘要
目的评价目前常用的几种影像学技术对肝硬化肝癌检查的准确性。方法将74例肝癌肝移植病例的术前彩色多普勒超声(BUS)、CT、MRI检查结果与术后病理解剖结果对照分析,从肿瘤大小(以长径进行对比,若术前影像学检查与标本解剖误差<1cm认为是符合)和数目两方面的诊断符合率来评估术前常用的影像学检查的可靠性。结果肿瘤数目术前影像学检查与术后病理解剖结果的符合率分别是:BUS38.8%(26/67),CT56.6%(30/53),MRI61.0%(36/59);肿瘤直径的符合率分别是:BUS38.3%(57/149),CT42.5%(54/127),MRI48.3%(71/147)。随着瘤灶直径增加,检查符合率逐步提高。直径≤1cm的肿瘤BUS、CT、MRI三者漏诊率分别为90·2%(37/41)、89.5%(34/38)及78.3%(36/46)。结论对肝硬化肝癌,目前常用的术前影像学检查方法均不完全符合于病理结果,并存在一定数量的假阳性及假阴性,仅依术前影像学检查报告确定治疗方案,尤其是作为肝切除与肝移植适应证的绝对标准时应考虑到这一因素。肝硬化肝癌影像学检查的准确性有待于进一步提高。
Objective To evaluate the accuracy of Doppler ultrasound （BUS） , computer tomography （CT） and magnetic resonance imaging （MRI） in the diagnosis of hepatocellular carcinoma. Methods A total of 74 patients with hepatocellular carcinoma and cirrhosis who received a liver transplantation was included in this study. We compared the postoperative pathological results with preoperative imaging findings （BUS, CT, and MRI）. An assessment was made in respect of the accuracy in tumor size （a diagnostic accordance was defined as 〈 1 cm of error in long axis between preoperative imaging findings and resected tumor） and lesion number of hepetocellular carcinoma. Results The overall diagnostic accuracy of BUS, CT, and MRI in tumor number was 38.8% （26/67） , 56.6% （30/53） , and 61.0% （36/59） , respectively, and in tumor diameter was 38.3% （57/149） , 42.5% （54/127） , and 48.3% （71/147） , respectively. With the increase of tumor diameter, the diagnostic accordance rate was improved. The rate of missed diagnosis in tumor with a diameter ≤ 1 cm was 90. 2% （37/41） for BUS, 89.5% （34/38） for CT, and 78.3% （36/46） for MRI, respectively. Conclusions All of the current imageological methods are not coincidence with the pathological results completely in patients with hepatocellular carcinoma and cirrhosis, with certain false positives and false negatives. It is unsuitable that just using the imaging findings to determine the therapeutic regimen, especially to determine patient＇ s eligibility for liver resection and liver transplantation. The accuracy of imageological examination of hepatocellular carcinoma with cirrhosis should be a new topic of research.
出处
《中国微创外科杂志》
CSCD
2007年第2期177-179,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
肝硬化
肝癌
肝移植
影像学
病理检查
Liver cirrhosis
Hepatocellular carcinoma
Liver transplantation
Imageology
Pathological examination
