摘要
目的 探讨多层螺旋CT联合MRI检查对乙型肝炎肝硬化背景小肝癌的诊断价值.方法 选取80例疑似乙型肝炎肝硬化背景小肝癌患者,均行多层螺旋CT和MRI检查.以病理检查结果为金标准,分析多层螺旋CT、MRI单独及联合检查对乙型肝炎肝硬化背景小肝癌的诊断价值.采用Kappa检验评估多层螺旋CT、MRI单独及联合检查诊断乙型肝炎肝硬化背景小肝癌的结果与病理检查结果的一致性.结果 多层螺旋CT检查诊断乙型肝炎肝硬化背景小肝癌的灵敏度为94.74%,特异度为75.00%,准确度为93.75%,阳性预测值为98.63%,阴性预测值为42.86%,其诊断结果与病理检查结果具有中等一致性(Kappa=0.515).MRI检查诊断乙型肝炎肝硬化背景小肝癌的灵敏度为96.05%,特异度为50.00%,准确度为93.75%,阳性预测值为97.33%,阴性预测值为40.00%,其诊断结果与病理检查结果具有中等一致性(Kappa=0.412).多层螺旋CT联合MRI检查诊断乙型肝炎肝硬化背景小肝癌的灵敏度为97.37%,特异度为75.00%,准确度为96.25%,阳性预测值为98.67%,阴性预测值为60.00%,其诊断结果与病理检查结果具有较高一致性(Kappa=0.647).结论 多层螺旋CT联合MRI检查对乙型肝炎肝硬化背景小肝癌的诊断效能较高,可提高诊断准确度,降低漏诊率.
Abstract
Objective To explore the diagnostic value of multi-slice spiral CT combined with MRI in small hepatic carcinoma with hepatitis B cirrhosis.Method A total of 80 patients with suspected small hepatic carcinoma with hepati-tis B cirrhosis were selected,and all patients received multi-slice spiral CT and MRI examinations.Using pathological ex-amination results as the gold standard,the diagnostic value of multi-slice spiral CT and MRI single and combined exami-nations in small hepatic carcinoma with hepatitis B cirrhosis were analyzed.The Kappa test was used to evaluate the con-sistency between the results of multi-slice spiral CT and MRI single and combined examinations and pathological exami-nation in the diagnosis of small hepatic carcinoma with hepatitis B cirrhosis.Result The sensitivity,specificity,accura-cy,positive predictive value,and negative predictive value of multi-slice spiral CT in the diagnosis of small hepatic carci-noma with hepatitis B cirrhosis were 94.74%,75.00%,93.75%,98.63%,42.86%,respectively,and the diagnostic results showed moderate consistency with pathological examination results(Kappa=0.515).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MRI in the diagnosis of small hepatic carcinoma with hepatitis B cirrhosis were 96.05%,50.00%,93.75%,97.33%,40.00%,respectively,and the diagnostic results showed moderate consistency with pathological examination results(Kappa=0.412).The sensitivity,specificity,accuracy,positive predic-tive value,and negative predictive value of multi-slice spiral CT combined with MRI in the diagnosis of small hepatic car-cinoma with hepatitis B cirrhosis were 97.37%,75.00%,96.25%,98.67%,60.00%,respectively,and the diagnostic re-sults showed high consistency with pathological examination results(Kappa=0.647).Conclusion Multi-slice spiral CT combined with MRI has high diagnostic efficiency for small hepatic carcinoma with hepatitis B cirrhosis,which can im-prove diagnostic accuracy and reduce the rate of missed diagnosis.
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