CAJ | 학술논문

目的：探讨肝脏增强CT与肝脏MRI在肝癌诊断中的应用价值。方法收集2010年1月-2013年12月期间肝胆外科就诊的100例患者，经肝胆彩色B超初筛均确定为肝脏中、小型占位病变。所有病例分别进行肝脏增强CT及MRI影像学检查，且最终经组织病理学确诊，以后者为金标准分析2种检查方法的诊断效能。结果肝脏增强CT检查与病理检查的一致性系数Kappa值为0．329，MRI与病理检查的Kappa值为0．709（Kappa值越高，说明一致性越好）（P＜0．05）；在各项诊断效能指标的对比中，MRI的准确度（91．0％）、灵敏度（93．7％）及阴性预测值（77．3％）均高于CT检查，差异具有统计学意义（P＜0．05）；两者共同诊断为阳性的病例为60例，CT诊断阳性而MRI诊断为阴性的病例为2例，CT诊断阴性而MRI诊断为阳性的病例为9例，两者共同诊断为阴性的病例为17例，配对卡方检验2种检查方法的诊断结果差异有统计学意义（P＜0．05）。结论 MRI在肝癌的检出率与准确度均高于肝脏增强CT，值得在临床推广应用。
목적：탐토간장증강CT여간장MRI재간암진단중적응용개치。방법수집2010년1월-2013년12월기간간담외과취진적100례환자，경간담채색B초초사균학정위간장중、소형점위병변。소유병례분별진행간장증강CT급MRI영상학검사，차최종경조직병이학학진，이후자위금표준분석2충검사방법적진단효능。결과간장증강CT검사여병리검사적일치성계수Kappa치위0．329，MRI여병리검사적Kappa치위0．709（Kappa치월고，설명일치성월호）（P＜0．05）；재각항진단효능지표적대비중，MRI적준학도（91．0％）、령민도（93．7％）급음성예측치（77．3％）균고우CT검사，차이구유통계학의의（P＜0．05）；량자공동진단위양성적병례위60례，CT진단양성이MRI진단위음성적병례위2례，CT진단음성이MRI진단위양성적병례위9례，량자공동진단위음성적병례위17례，배대잡방검험2충검사방법적진단결과차이유통계학의의（P＜0．05）。결론 MRI재간암적검출솔여준학도균고우간장증강CT，치득재림상추엄응용。
Objective To discuss and analyze the application value of liver enhanced CT and liver MRI in diagnosing liver cancer .Methods 100 patients visited department of hepatobiliary surgery were chosen and given preliminary screening by color B-ultrasound and diagnosed as liver medium and small space occupying lesions .All cases were given liver enhanced CT and MRI examinations and finally confirmed by histopathology .The latter was taken as golden standard to analyze the diagnostic effi-ciency of the 2 kinds of examination methods .Results Consistency coefficient Kappa value of liver enhanced CT and pathological examination was 0.392,and that of MRI and pathological examination was 0.709(the higher the value,the better the consistency) (P<0.05);on comparison of diagnostic efficiency indicators ,accurate rate(91.0%),sensitivity(93.7%)and negative predic-tion value(77.3%)of MRI were all higher than those of CT(P<0.05);there were 60 cases diagnosed as positive by both CT and MRI,2 cases diagnosed as positive by CT but negative by MRI ,9 cases diagnosed as negative by CT but positive by MRI ,17 cases diagnosed as negative by both CT and MRI (P<0.05).Conclusion MRI has a higher detection rate and accurate rate than liver enhanced CT in diagnosing liver cancer ,and it is worthy of clinical application .