CT诊断在鉴别肝细胞癌及肝胆管细胞癌中应用.docVIP

CT诊断在鉴别肝细胞癌及肝胆管细胞癌中应用 　　[摘要] 目的 探讨CT诊断在鉴别肝细胞癌与肝胆管细胞癌中的应用效果。方法 方便选取2013年9月―2016年7月该院收治的经手术证实的63例肝?胞癌患者及20例肝胆管细胞癌患者进行研究，分别对所有患者行B超检查和64排螺旋CT动态增强扫描，比较两种检查方式的诊断效能。结果 CT诊断肝细胞癌的病理诊断符合率为92.1%，肝胆管细胞癌的病理诊断符合率为85.0%； B超分别为77.8%和55.0%，CT诊断肝细胞癌和肝胆管细胞癌的病理诊断符合率均明显高于B超。肝细胞癌患者中合并肝硬化、HBsAg阳性、AFP升高等人数明显多于肝胆管细胞癌患者，合并结石及淋巴结转移者明显少于肝胆管细胞癌；CT诊断肝细胞癌和肝胆管细胞癌存在特异性差异。 结论 螺旋CT增强扫描与延迟扫描能有效提高肝细胞癌和肝胆管细胞癌的诊断准确率，且可结合患者的临床资料及并发症影像学检查结果对二者进行鉴别，具有较高的临床应用价值 [关键词] 肝细胞癌；肝胆管细胞癌；CT诊断；鉴别诊断 [中图分类号] R445 [文献标识码] A [文章编号] 1674-0742（2016）12（c）-0190-03 [Abstract] Objective To investigate the application effect of CT in the diagnosis of hepatocellular carcinoma and cholangiocarcinoma. Methods Convenient selection 63 cases of hepatocellular carcinoma and 20 cases of hepatocellular carcinoma in our hospital were studied. The diagnostic efficacy of the two methods of dynamic enhanced scan and spiral CT scan in all patients were compared. Results The pathological diagnosis of CT diagnosis of hepatocellular carcinoma with the rate of 92.1%， the pathological diagnosis of hepatobiliary cancer with the rate of 85.0%； B were 77.8% and 55.0%， pathological diagnosis coincidence rate of CT diagnosis of hepatocellular carcinoma and liver and gallbladder carcinoma were significantly higher than the rate of B ultrasound diagnosis. The number of patients with hepatocellular carcinoma complicated with cirrhosis， HBsAg positive， AFP were significantly higher than those in hepatocholangiocarcinoma patients， with stones and lymph node metastasis were significantly less than those of hepatocholangiocarcinoma patients. There is specific differences between CT diagnosis of hepatocellular carcinoma and hepatocholangiocarcinoma. Conclusion Spiral CT scan and delayed scan can effectively improve the diagnosis of hepatocellular carcinoma and hepatocholangiocarcinoma accuracy and examination results， identify hepatocellular carcinoma and hepatocholangiocarcinoma combination of the clinical data and complications of patients， it has a