实用肝脏病杂志2024，Vol.27Issue(2)：275-278,4.DOI:10.3969/j.issn.1672-5069.2024.02.029
能谱CT增强扫描参数鉴别诊断肝血管瘤与肝细胞癌价值研究
Differentiation of hepatocellular carcinoma from hepatic hemangioma by using contrast-enhanced energy spectrum CT parameters
摘要
Abstract
Objective The aim of this study was to investigate the differentiation of hepatocellular carcinoma(HCC)from hepatic hemangioma(HH)by using contrast-enhanced energy spectrum CT parameters.Methods 78 patients with primary intrahepatic space-occupying lesions were encountered in our hospital between January 2021 and December 2022,and all patients underwent hepatectomy.The postoperative histopathological examination revealed 46 patients with HH and 32 patients with HCC.At presentation,all patients received plain and enhanced energy spectrum CT scanning,and the iodine(water)concentration(IC),water(iodine)concentration(WC),iodine uptake ratio(IUR)of lesions,and slope of energy spectrum curve of lesions at 50,60,70,80 and 90 keV single-energy CT values were recorded.The kappa coefficient test was applied to analyze the diagnostic performance of CT parameters.Results The foci CT values at 5 single energy levels of arterial phase in patients with HCC were(152.3±48.5),(117.5±41.6),(95.2±34.3),(83.1±29.8)and(70.5±25.3),all significantly higher than[(81.4±29.6),(66.5±21.4),(58.9±16.5),(54.6±15.2)and(48.3±13.5),respectively,P＜0.05],and the foci CT values at 5 single energy levels of portal phase were(177.5±51.2),(130.9±35.9),(106.8±22.8),(85.9±20.3)and(74.6±19.8),all significantly higher than[(130.9±46.3),(105.8±31.7),(84.6±22.9),(73.4±20.5)and(64.2±15.9),respectively,P＜0.05]in HH foci;the arterial IC,IUR and energy spectrum curve in patients with HCC were(2.0±0.6),(2.7±0.5)and(2.8±0.9),significantly higher than[(0.8±0.2),(1.3±0.4)and(1.0±0.3),P＜0.05],and the portal IC,IUR and energy spectrum curve were(2.6±0.8),(0.9±0.3)and(3.5±1.1),significantly higher than[(1.7±0.5),(0.6±0.2)and(2.5±0.8),P＜0.05]in HH foci;the sensitivity,specificity and accuracy were 90.6%,89.1%and 89.7%when the arterial and portal CT parameter were combined for the prediction of HCC,which was much consistent with histopathological examination(Kappa=0.790).Conclusion The energy spectrum CT enhanced scanning might help differentiate the HCC from HH,and needs further clinical investigation.关键词
肝细胞癌/肝血管瘤/能谱CT成像/诊断Key words
Hepatoma/Hepatic hemangioma/Energy spectrum CT imaging/Diagnosis引用本文复制引用
崔甜甜,张海波,陈莉莉..能谱CT增强扫描参数鉴别诊断肝血管瘤与肝细胞癌价值研究[J].实用肝脏病杂志,2024,27(2):275-278,4.基金项目
江苏省卫生健康委员会科研面上项目(编号:M2020064) （编号:M2020064）
