摘要
目的分析超声造影与增强CT在 甲胎蛋白(AFP)阴性肝占位性病变诊断中 的价值。方法 选择2015年11月至2017年 10月我院收治的57例AFP阴性肝占位性病 变患者为研究对象,均进行超声造影与增 强CT检查,以手术病理检查为金标准,比 较超声造影与增强CT对AFP阴性肝占位性 病变的诊断价值。结果 肝脏恶性病变的 超声造影始增时间、达峰时间、渡越时间 和峰值强度均与良性病变、周围肝脏实 质具有显著差异(P<0.05)。超声造影检 测AFP阴性肝恶性占位性病变灵敏度、特 异度、准确度分别为87.18%、94.44%、 89.47%,增强CT检测AFP阴性肝恶性占位 性病变灵敏度、特异度、准确度分别为 82.05%、88.89%、84.21%。结论 超声造 影与增强CT对AFP阴性肝占位性病变均有 较高的诊断价值。
Objective To analyze the value of ultrasound contrast and enhanced CT in the diagnosis of alpha fetoprotein (AFP)-negative hepatic space-occupying lesions. Methods A total of 57 cases of patients with AFP-negative hepatic space-occupying lesions treated in our hospital from November 2015 to October 2017 were selected for the study and were given ultrasound contrast and enhanced CT. Surgical pathology was used as the gold standard, and the diagnostic values of ultrasound contrast and enhanced CT were compared in the diagnosis of AFP-negative hepatic space-occupying lesions. Results The beginning enhancement time, beginning reduction time and transition time of ultrasound contrast in hepatic malignant lesions were all significantly different from those in benign lesions and surrounding liver parenchyma (P<0.05). The sensitivity, specificity and accuracy in detecting AFP-negative hepatic space-occupying lesions were 87.18%, 94.44%, and 89.47% respectively by ultrasound contrast and were 82.05%, 88.89% and 84.21% respectively by enhanced CT. Conclusion Ultrasound contrast and enhanced CT both have a certain diagnostic value for AFP-negative hepatic space-occupying lesions.
【关键词】超声造影;增强CT;AFP阴性肝占位性病变;诊断
【中图分类号】R816
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.09.028
前言
甲胎蛋白(AFP)是一种酸性糖蛋白,主要由胎儿肝细胞及卵黄囊合 成,出生后水平下降,健康成人血清中AFP水平极低,而对于原发性肝 癌患者,AFP是其诊断和疗效评估的重要监控指标。但是,部分肝癌 AFP呈阴性,且其常规影像学特征也不典型,极易造成误诊或漏诊。超 声造影作为近年来快速发展的新技术,具有副作用低、造影剂使用剂 量低、安全可靠等优势,并且是纯血池显像,能够显示小血管内血流 信号,对于准确反映病变内血流灌注具有一定的优势,而增强CT开始 应用时间较早,诊断技术更为成熟,在显示肿瘤血管浸润情况,反映 病变范围和肿瘤侵犯情况以及肝脏整体性的观察等方面具有其独到的 优势[1-2]。本次研究对超声造影与增强CT诊断AFP阴性肝占位性病变情 况进行分析比较,以期对肝脏占位病变的良恶性诊断提供更为可靠的 依据。具体报道如下。
中国CT和MRI杂志
第16卷, 第 9 期
2018年09月
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