摘要
目的探讨多排螺旋CT(MSCT)在脂肪肝背景下鉴别诊断肝脏结节性疾病中的临床价值。方法选取2013年3月至2016年3月经病理确诊的280例脂肪肝合并肝脏结节性疾病患者的影像学资料进行回顾性分析,所有患者均接受了超声、MSCT检查,以病理学结果作为诊断标准,分别计算两种影像学方法鉴别诊断脂肪肝合并肝脏结节性疾病的诊断学价值。数据统计分析采用SPSS 18.0进行处理,计算灵敏度、特异度、漏诊率、误诊率及绘制受试者工作曲线(ROC),计数资料采用%进行描述;组间比较采用χ2检验;P<0.05表示差异有统计学意义。结果 280例患者共检出338个结节,经病理诊断其中188例良性患者检出良性结节227个(67.1%),92例恶性患者共检出恶性结节111个(32.8%);MSCT鉴别诊断脂肪肝良恶性结节的灵敏度为90.99%、特异度为91.63%、漏诊率9.01%、误诊率8.37%、ROC曲线下面积AUC值为0.922;超声鉴别诊断脂肪肝良恶性结节的灵敏度为61.26%、特异度为69.60%、漏诊率38.74%、误诊率30.40%、ROC曲线下面积AUC值为0.684。MSCT鉴别诊断脂肪肝良恶性结节的灵敏度、特异度均高于超声(P<0.05),漏诊率和误诊率均低于超声(P<0.05)。结论 MSCT在脂肪肝背景下鉴别诊断肝脏结节性疾病具有较高的临床价值。
Objective To investigate the clinical value of multi-slice spiral CT（MSCT）in the differential diagnosis of hepatic nodules combined with fatty liver.Methods From March 2013 to March 2016,imaging data of 280 patients with both fatty liver and hepatic nodules were analyzed retrospectively,all of whom underwent ultrasound and MSCT examination.The diagnostic criteria of two imaging methods were analyzed respectively.The diagnostic value of the differential diagnosis of fatty liver and hepatic nodular disease were calculated respectively.Statistical analysis of data were performed by using SPSS 18.0 software,including sensitivity,specificity,missed diagnosis rate,misdiagnosis rate and receiver operating curve（ROC）.Count data were expressed as%,and were examined by using x2 test.A P value 〈0.05 was considered as statistically significant difference.Results A total of 338 nodules were detected in 280 patients,while 227 nodules（67.1%）were confirmed as benign nodules by pathological examination in 188 cases and 111 malignant nodules（32.8%）were detected in 92 patients.Sensitivity of MSCT in differential diagnosis of benign and malignant nodules was 90.99%in condition of fatty liver,with specificity o 91.63%,missed diagnosis rate of 9.01%,misdiagnosis rate of 8.37%,and the area under the ROC curve AUC value fo 0.922.The sensitivity of ultrasound in differential diagnosis of benign and malignant hepatic nodules was 61.26%,the specificity was 69.60%,the rate of missed diagnosis was 38.74%,the misdiagnosis rate was 30.40%.The area under the ROC curve AUC was 0.684.The sensitivity and specificity of MSCT differential diagnosis of benign and malignant hepatic nodules were significantly higher than those by using ultrasound（P〈0.05）.The rate of missed diagnosis and misdiagnosis rate were significantly lower than those by using ultrasound（P〈0.05）.Conclusion There is a high clinical value of MSCT in differential diagnosis of liver nodular disease in condition of fatty liver.
作者
杨耀华
Yang Yaohua(Medical Imaging Department of Huanggang central hospital, Huanggang 438000, Chin)
出处
《中华普外科手术学杂志（电子版）》
2017年第2期168-170,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
脂肪肝
体层摄影术
螺旋计算机
局限性结节增生
诊断
鉴别
Fatty liver
Tomography
spiral computed
Focal nodular hyperplasia
Diagnosis
differential
