摘要
目的 探讨增强CT扫描对TAEC术后原发性肝癌患者的疗效.方法 选取濮阳市安阳地区医院微创介入科于2020年2月1日至2023年2月1日收治的97例(108个病灶)原发性肝癌患者作为研究对象.全部患者采取TAEC手术治疗,术后行增强CT扫描及数字减影血管造影(DSA)检查,以DSA诊断结果作为"金标准",采用增强CT扫描技术对原发性肝癌(primary liver cancer,PLC)患者行介入术后的疗效进行评估,分析其诊断准确性、特异性及灵敏性等,以评价该技术的应用价值.结果 DSA检查发现,97例患者共计108个病灶.其中,47个(43.92%)病灶完全灭活,61个(56.08%)病灶残留.经增强CT扫描发现,97例患者共计108个病灶.其中,46个(42.59%)病灶完全灭活,62个(57.41%)病灶残留;增强扫描CT扫描诊断PLC患者TAEC术治疗后阳性病灶准确度为95.37%(103/108),灵敏度为96.72%(59/61),特异度93.62%(44/47),阳性预测值为95.16%(59/62),阴性预测值为95.65%(44/46);与CT平扫相比,增强CT扫描对PLC患者TAEC术后病灶大小、供血动脉来源的诊断灵敏度、特异度均显著增高(P<0.05);在PLC患者TAEC术后复发方面,增强CT扫描与DSA检查结果差异不显著(P>0.05).以DSA检查为金标准,增强CT扫描检查患者术后复发的灵敏度为98.46%(64/65),特异度为97.67%(42/43),阳性预测值为98.44%(63/64),阴性预测值为95.45%(42/44).结论 增强CT扫描对TAEC术后原发性肝癌患者评估具有较高的应用价值.
Abstract
Objective To investigate the effect of enhanced CT scanning on primary liver cancer patients after TAEC.Methods Ninety-seven patients(108 lesions)with primary liver cancer admitted to the minimally invasive interven-tion department of our hospital from February 1,2020 to February 1,2023 were selected as the research objects.All pa-tients were treated with TAEC surgery,and underwent enhanced CT scanning and digital subtraction angiography(DSA)examination after surgery.With DSA diagnosis as the"gold standard",enhanced CT scanning technology was used to e-valuate the efficacy of interventional surgery in patients with primary liver cancer(PLC).The diagnostic accuracy,spe-cificity and sensitivity were analyzed to evaluate the application value of the technique.Results DSA showed 108 le-sions in 97 patients.Among them,47(43.92%)lesions were completely inactivated and 61(56.08%)lesions re-mained.Enhanced CT scan revealed 108 lesions in 97 patients.Among them,46(42.59%)lesions were completely inactivated and 62(57.41%)lesions remained.The accuracy,sensitivity,specificity and positive predictive value of enhanced CT scanning in the diagnosis of positive lesions in PLC patients after TAEC were 95.37%(103/108),96.72%(59/61),93.62%(44/47)and 95.16%(59/62)respectively.The negative predictive value was 95.65%(44/46).Compared with plain CT scan,enhanced CT scan significantly increased the diagnostic sensitivity and speci-ficity of lesion size and donor artery source in PLC patients after TAEC(P<0.05).There was no significant difference between enhanced CT scan and DSA in the recurrence of PLC patients after TAEC(P>0.05).Using DSA as the gold standard,the sensitivity and specificity of enhanced CT scanning for postoperative recurrence were 98.46%(64/65),97.67%(42/43),98.44%(63/64)and 95.45%(42/44)respectively.Conclusion Enhanced CT scan has high application value in the evaluation of primary liver cancer patients after TAEC.