CAJ | 학술논문

目的：研究低剂量64层螺旋CT扫描和超声造影诊断对小肝癌(Small hepatic carcinoma,SHCC)的临床诊断价值。方法研究年限为2012年12月-2014年12月，对象为38例经门诊和住院部收治的超声检查提示为肝脏发生占位性病变的患者，所有患者均接受超声造影检查(A组)、低剂量64层螺旋CT双动脉期多期扫描(B组)和两种联合检查(C组)。对三组患者的诊断结果进行对照。结果 A组检查的灵敏性(81.85%)、特异性(78.95%)、准确率(76.32%)；B组检查的灵敏性(78.95%)、特异性(84.21%)、准确率(73.68%)；组间比较*P、**P、#P均＞0.05，无显著差异。C组检查的灵敏性(98.24%)、特异性(100.00%)、准确率(94.74%)；分别与A组和B组比较，*P、**P、#P＜0.05，统计学差异显著。B组检查中SHCC病灶主要表现为典型的“快进快出”强化征象，误诊率为2.63%。A组检查中误诊率为5.26%。结论64层螺旋CT双动脉期多期扫描联合超声造影对SHCC的诊断均具有较高的准确率、灵敏性和特异性，其能够对缺乏血供、不典型的SHCC肝癌进行准确诊断，建议在临床诊断中优先选择使用。
목적：연구저제량64층라선CT소묘화초성조영진단대소간암(Small hepatic carcinoma,SHCC)적림상진단개치。방법연구년한위2012년12월-2014년12월，대상위38례경문진화주원부수치적초성검사제시위간장발생점위성병변적환자，소유환자균접수초성조영검사(A조)、저제량64층라선CT쌍동맥기다기소묘(B조)화량충연합검사(C조)。대삼조환자적진단결과진행대조。결과 A조검사적령민성(81.85%)、특이성(78.95%)、준학솔(76.32%)；B조검사적령민성(78.95%)、특이성(84.21%)、준학솔(73.68%)；조간비교*P、**P、#P균＞0.05，무현저차이。C조검사적령민성(98.24%)、특이성(100.00%)、준학솔(94.74%)；분별여A조화B조비교，*P、**P、#P＜0.05，통계학차이현저。B조검사중SHCC병조주요표현위전형적“쾌진쾌출”강화정상，오진솔위2.63%。A조검사중오진솔위5.26%。결론64층라선CT쌍동맥기다기소묘연합초성조영대SHCC적진단균구유교고적준학솔、령민성화특이성，기능구대결핍혈공、불전형적SHCC간암진행준학진단，건의재림상진단중우선선택사용。
Objective This paper is to investigate clinical diagnosis value of low dose of 64–slice spiral CT scanning and contrast-enhanced ultrasonically in the diagnosis of Small hepatic carcinoma. Methods The years of research extended from December, 2012 to December, 2014, and research subjects were 38 patients admitted by the outpatient clinic and the inpatient department were indicated to suffer from liver space-occupying lesions via ultrasonic examination, 19 patients in the control group were subject to low dose of 64-slice spiral CT multi-phase scanning, and 19 patients in the experiment group were subject to contrast-enhanced ultrasonically. Diagnosis results of patients in two groups were compared on the basis of clinically pathological diagnosis. Results The sensitivity (100.00%) and accuracy (94.74%) of CT examination were higher than those of ultrasound examination (96.63% and 94.44%), but the specificity (98.24%) of CT examination was lower than that of ultrasound examination (100.00%).The inter-group comparison satisfied P>0.05,and there is no significant difference. Medium and small unicellular carcinoma lesions in CT examination mainly manifested enhanced sign of typical "Fast-out and Fast-in" with misdiagnosis rate ar 5.26%. Conclusion Diagnosis of 64 slice spiral CT scan combined with double arterial phase of contrast-enhanced ultrasound on SHCC has higher accuracy, sensitivity and specificity, which can lack of blood supply, not the typical SHCC unicellular carcinoma by accurate diagnosis, to recommend the preferred option for use in clinical diagnosis.