多层螺旋CT多平面重建技术在胆管细胞癌诊断中的应用

目的分析多层螺旋CT(MSCT)多平面重建技术(MPR)在胆管细胞癌(cholangiocellular carcinoma,CCA)诊断中的应用。方法回顾性分析2013年7月~2018年3月在我院拟拟诊CCA的116例患者的临床资料,均有明确手术病理结果,MSCT检测结果完整,以病理结果对照,比较MSCT增强扫描、MPR对CCA的诊断价值。结果经手术病理确诊,CCA94例,其中周围型24例,肝门型42例,肝外28例,其余22例非CCA;MSCT增强扫描诊断CCA灵敏度为78.72%、特异度为50.00%、准确率为73.27%,阳性预测值87.05%、阴性预测值35.48%,kappa值0.245;MPR诊断CCA灵敏度为85.10%、特异度为59.09%、准确率为80.17%,阳性预测值89.88%、阴性预测值48.14%,kappa值0.406,与MSCT增强扫描比较,MPR灵敏度、特异度、准确率、阳性预测值及阴性预测值均较高,组间差异无统计学意义(P>0.05),但MRPkappa值(0.406vs0.245)高于MSCT增强扫描。结论结合MPR诊断,或可进一步提升MSCT对CCA的诊断价值,值得临床深入探究。

Application of Multi-slice Spiral CT Multiplanar Reconstruction in the Diagnosis of Cholangiocarcinoma

Objective To analyze the application of multi-slice spiral CT(MSCT)multiplanar reconstruction(MPR)in the diagnosis of cholangiocarcinoma(CCA).Methods The clinical data of 116 patients with CCA diagnosed in the hospital from July 2013 to March 2018 were retrospectively analyzed.The results of surgery and pathology were confirmed and results of MSCT were complete.With pathological results as controls,the diagnostic value of MSCT enhanced scan and MPR for CCA was compared.Results Surgery and pathology confirmed that there were 94 cases of CCA,including 24 cases of peripheral type,42 cases of hepatic portal type,28 cases of extrahepatic type and 22 cases of non-CCA.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and kappa value of CMSC enhanced scan for diagnosis of CCA were 78.72%,50.00%,73.27%,87.05%,35.48%and 0.245,respectively.However,those of MPR were 85.10%,59.09%,80.17%,89.88%,48.14%and 0.406,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MPR were higher than those of MSCT enhanced scan(P>0.05),but the kappa value of MRP was higher than that of MSCT enhanced scan(0.406 vs 0.245).Conclusion Combined diagnosis with MPR may further enhance the diagnostic value of MSCT for CCA.