The application value of multi-slice spiral CT enhanced scan in the diagnosis of liver diseases
Objective To explore the application value of multi-slice spiral CT enhanced scan in the diagnosis of liver diseases.Methods 300 patients with suspected liver disease were selected and examined by multi-slice spiral CT enhanced scan.The diagnostic efficacy(sensitivity,specificity,positive predictive value,negative predictive value and accuracy),consistency and imaging features of multi-slice spiral CT enhanced scan were analyzed using the pathological results of have liver biopsy as the gold standard.Results Among the 300 patients with suspected liver disease,216 cases were found to liver disease and the remaining 84 cases were others by the gold standard.The results of multi-slice spiral CT enhanced scan were 212 patients with liver disease and 88 patients with other diseases.The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of multi-slice spiral CT enhanced scan were 95.83%(207/216),94.05%(79/84),95.33%(286/300),97.64%(207/212)and 89.77%(79/88)respectively.The results of multi-slice spiral CT enhanced scan were highly consistent with those of liver biopsy(kappa=0.787).Among 216 patients with confirmed liver disease,100 of them had obvious lesions in the liver.Among the 216 patients,20 patients had multiple small enhanced lesions in the liver,and 3 patients had multiple small lesions in the liver that were not indicated after plain scan and ultrasound examination.In the second-phase scan,i.e.,portal vein phase,the images showed that the inferior vena cava,portal vein and its branches,splenic vein and hepatic vein could be clearly visualized in 216 patients,with homogeneous enhancement of the spleen and homogeneous enhancement of the hepatic parenchyma.The 40 patients with enhanced lesions in the first-phase scan showed a significant decrease in density in the second-phase scan,with hypodense shadows,and 12 of them had filling defects in the portal trunk.In 20 patients who did not show significant changes in the arterial phase,the margins showed irregular enhancement in the second-phase scans,and in the third-phase or delayed-phase scans,the lesions were seen to gradually fill with contrast toward the center in these 20 patients,and the lesions of another 10 patients showed irregular enhancement in the second-phase scans.After combining patient images with clinical symptoms,it was found that among the 216 patients,100 patients were diagnosed with hepatic hemangioma,70 patients were diagnosed with primary liver cancer,30 patients had multiple intrahepatic metastases and portal vein thrombosis,and 16 patients were diagnosed with hepatic abscess.The main sources of liver blood supply are the portal vein and the intrahepatic artery,in which the hepatic artery accounts for more than 20%of the total hepatic blood flow.Conclusion The diagnostic accuracy of multi-slice spiral CT enhanced scan is higher when diagnosing patients with liver diseases,and clinicians can more comprehensively understand the patient's liver lesions and their surrounding conditions,which is of significant clinical value.
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