超声与增强CT测量原发性肝癌大小的结果对比

目的 比较超声、增强CT测量原发性肝癌大小的结果.方法 回顾性分析189例原发性肝癌患者的超声、增强CT检查结果,其中55例有术后病理标本.比较超声、增强CT对大病灶(CT测量长径>5 cm,共77例)、小病灶(CT测量长径≤5 cm,共112例)长径的测量结果,并采用Bland-Altman分析评价两者测量结果的一致性;比较超声、增强CT、术后病理测量对小病灶标本(CT测量长径≤5 cm,共47例)长径的测量结果,评价超声、增强CT与病理测量的一致性.结果 超声与增强CT对小病灶的测量结果比较差异有统计学意义(P<0.05),而对大病灶的测量结果比较差异无统计学意义(P>0.05),两者对大病灶的测量结果具有较好的一致性.超声测量的小病灶长径大于病理测量(P<0.05),而增强CT与病理的测量结果比较差异无统计学意义(P>0.05),两者对小病灶的测量结果与病理测量结果的一致性均较差.结论 对于大的肝癌病灶,增强CT与超声的测量结果无明显差异,可相互替代,而对于小病灶,增强CT的测量结果可能会更准确,但两者均不能替代病理测量结果.

Comparison between ultrasound and enhanced CT for measurement of primary hepatic carcinoma size

Objective To compare the measurement results of primary hepatic carcinoma size between ultrasound and enhanced CT.Methods The data of ultrasound and enhanced CT examination from 189 patients with primary hepatic carcinoma were retrospectively analyzed. And the postoperative pathological specimens were collected from 55 cases.The measurement results of large lesions (major diameter>5 cm by CT;n=77) and small lesions(major diameter≤5 cm by CT;n=112) were compared between ultrasound and enhanced CT,and Bland-Altman analysis was used to evaluate the consistency of the two approaches .The measurement results of small lesions ( major diameter≤5 cm by CT;n=47) were compared among ultrasound ,enhanced CT and pathological measurement after operation ,and the consistencies of ultrasound and enhanced CT with pathological measurement were evaluated .Results Significant difference in the measurement result of small lesions was found between ultrasound and enhanced CT (P<0.05),but no significant difference in the measurement result of large lesions was found (P>0.05).Consistency between enhanced CT and ultrasound was observed in the measurement for large lesions .The major diameter of small lesions measured by ultrasound was greater than that by pathological measurement (P<0.05),but there was no significant difference between enhanced CT and pathological measurement (P>0.05).Poor consistency between enhanced CT (or ultrasound) and pathological measurement was observed in the measurement for small lesions.Conclusion For the large lesions of hepatic carcinoma,there is no significant difference in the measurement result between enhanced CT and ultrasound ,and they can be replaced with each other.And for the small lesions, the results measured by enhanced CT might be more accurate.However,enhanced CT or ultrasound can not be a substitute for the pathological measurement.