摘要
目的探讨综合影像诊断在肝癌诊断与临床病理特征判断中的应用价值。方法对本院１９９１～１９９８年间手术治疗的肝癌３０４例做回顾性总结。总的ＴＮＭ分期分别为Ⅰ期６例、Ⅱ期５５例、Ⅲ期１３５例、ⅣＡ期７０例、ⅣＢ期３８例。行彩色超声波检查２３９例、增强ＣＴ２１４例、ＭＲＩ１２３例、ＤＳＡ８４例、ＮＩ（核素显像）２１例。结果各种检查肝癌诊断符合率分别是彩色超声波检查８７０％，增强ＣＴ８９２％（１９１／１２４），ＭＲＩ９０２％（１１１／１２３），ＤＳＡ９０５％（７６／８４）。各种检查所见肝癌临床病理特征与手术后临床病理诊断均有一定差距，其中增强ＣＴ比其它方法为好，但对肝癌卫星灶、脉管癌栓、淋巴结转移三者的检出率仍比较低，分别为５４％（４２／７８），４８％（２８／５８）和２８％（８／２９）。结论各种影像检查对较小的卫星灶、脉管癌栓和淋巴结转移的检出均存在一定的局限性。
Objective To evaluate the value of several image modalities used in daily clinical practice for the diagnosis and staging of primary liver cancer (PLC).Methods The clinical data of 304 patients undergoing surgical treatment for PLC from 1988 to 1996 were retrospectively analyzed. TNM staging of Ⅰ/Ⅱ /Ⅲ/ ⅣA/ⅣB was 6/55/135/70/38 cases, respectively. Imaging modalities as Doppler US, conventional enhancement CT (CECT), MRI, DSA and nuclear imaging (NI) were performed in 239, 214, 123, 84 and 21 cases. Results The correct diagnostic rate of Doppler US, CECT, MRI and DSA was 87 0%, 89 3%,90 7% and 90 5%, respectively The stages of PLC judged by any imaging modality were less satisfactory compared with the actual clinical stages made by surgical exploration. The detection rates of satellite focus, tumor emboli in vessels and lymphatic metastasis by CECT were higher than other imaging modalities,but even that were only 53 8%, 48 3% and 27 6%, respectively. Conclusion Imaging modality is limited in their value to discover satellite focus, tumor emboli in vessels and lymphatic metastasis.
出处
《中华普通外科杂志》
CSCD
1999年第3期182-184,共3页
Chinese Journal of General Surgery
关键词
肝肿瘤
肝细胞癌
影像学诊断
临床病理
Carcinoma,hepatocellular Surgery,operative Pathology, clinical Tomography,X Ray computed
