超声造影联合增强CT早期诊断原发性肝癌的临床价值研究

StephenW

超声造影联合增强CT早期诊断原发性肝癌的临床价值研究
张立波 1 2 , 顾俊义 3 , 雅丽 4 , 真人 4 , 张博 1 3 , 于作人 1 2
隶属关系
隶属关系

    1
    南京医科大学上海东方医学院超声医学教研室，上海 200120
    2
    同济大学附属东方医院转化医学研究中心,上海 200120
    3
    同济大学附属东方医院医学超声科，上海 200120
    4
    大连医科大学基础医学院,辽宁大连116027

    PMID：36101800 PMCID：PMC9462989 DOI：10.1155/2022/7130533

抽象的

目的：探讨超声造影联合增强CT在原发性肝癌（PHC）早期诊断中的临床价值。

方法：选取2020年1月至2022年1月在我院收治的84例早期疑似PHC患者作为研究对象。所有患者均行超声造影及增强CT检查，1个月内完成病灶切除手术。根据术后病理诊断结果，分为良性组和恶性组。回顾性研究回顾性研究病例资料，通过评估超声造影、增强CT及其组合对PHC的诊断效率，分析其临床应用价值。

结果：84例疑似患者中，术后病理组织学检查发现PHC（恶性组）70例，其他肝脏病变（良性组）14例。两组在年龄、性别、临床症状、文化程度等方面差异无统计学意义（P > 0.05），慢性肝病史、吸烟、饮酒、乙型肝炎病毒（HBV）感染等方面差异明显两组之间（P < 0.05）。两组增强时间和消退时间差异有统计学意义（P < 0.05），摄影增强模式差异无统计学意义（P > 0.05）。对于PHC患者，两种检查方法在动脉期和滞后期的影像学特征差异有统计学意义（P < 0.05）。以病理结果为金标准，联合诊断的准确性、敏感性、特异性、阳性预测值和阴性预测值均显着高于超声造影和增强CT（P < 0.05），联合诊断下面积显着高于超声增强和CT增强（P < 0.05）。联合诊断曲线明显大于超声造影和放置ROC曲线检查的增强CT（P < 0.05）。

结论：超声造影联合增强CT对PHC的早期诊断具有更高的准确性，超声造影的诊断效率高于增强CT。在临床实践中，应充分考虑患者的身体状况和病情，结合患者的经济状况，选择最合适的检查方式，减轻患者的医疗负担。

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StephenW

Clinical Value Study on Contrast-Enhanced Ultrasound Combined with Enhanced CT in Early Diagnosis of Primary Hepatic Carcinoma
Libo Zhang  1   2 , Junyi Gu  3 , Ya Li  4 , Zhen Ren  4 , Bo Zhang  1   3 , Zuoren Yu  1   2
Affiliations
Affiliations

    1
    Department of Ultrasound Medicine, Shanghai Oriental Clinical College of Nanjing Medical University, Shanghai 200120, China.
    2
    Research Center for Translational Medicine, Dongfang Hospital Affiliated to Tongji University, Shanghai 200120, China.
    3
    Department of Medical Ultrasound, Dongfang Hospital Affiliated to Tongji University, Shanghai 200120, China.
    4
    School of Basic Medical Sciences, Dalian Medical University, Dalian 116027, Liaoning, China.

    PMID: 36101800 PMCID: PMC9462989 DOI: 10.1155/2022/7130533

Abstract

Objective: To explore the clinical value of contrast-enhanced ultrasound combined with enhanced CT in the early diagnosis of primary hepatic carcinoma (PHC).

Methods: 84 patients with suspected PHC in the early stage treated in our hospital from January 2020 to January 2022 were selected as the study subjects. All patients underwent contrast-enhanced ultrasound and enhanced CT examinations, and the surgery was performed for resection of lesions within 1 month. According to the results of postoperative pathology diagnosis, the benign group and the malignant group were included. The case data were viewed for the retrospective study to analyze the clinical application value by evaluating the diagnostic efficiency of contrast-enhanced ultrasound, enhanced CT, and their combination for PHC.

Results: Among 84 suspected patients, 70 patients had PHC (malignant group) and 14 patients had other hepatic lesions (benign group) after postoperative histopathological examination. There was no significant difference in age, gender, clinical symptoms, and educational level between the two groups (P > 0.05), with obvious differences in the history of chronic hepatic disease, smoking, drinking, and infection of hepatitis B virus (HBV) between the two groups (P < 0.05). The enhancement time and regression time of the two groups were significantly different (P < 0.05), with no statistical difference in the enhancement pattern of photography (P > 0.05). For patients with PHC, the imaging features of the two inspection methods at arterial phase and lag phase were statistically different (P < 0.05). Taking pathologic findings as the gold standard, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of joint diagnosis were significantly higher than those of contrast-enhanced ultrasound and enhanced CT (P < 0.05), and the area under the curve of joint diagnosis was obviously larger than that of contrast-enhanced ultrasound and enhanced CT by placing the ROC curve for examination (P < 0.05).

Conclusion: The combination of contrast-enhanced ultrasound and enhanced CT has a higher accuracy in the early diagnosis of PHC, and the diagnostic efficiency of contrast-enhanced ultrasound is higher than that of enhanced CT. In clinical practice, the physical condition and state of illness in patients should be fully considered, and the most suitable examination method should be selected to reduce their medical burden by taking into account their economic situation.

Copyright © 2022 Libo Zhang et al.
Conflict of interest statement

The authors declare that there are no conflicts of interest.

StephenW

https://downloads.hindawi.com/journals/cmmi/2022/7130533.pdf