64层螺旋CT三维成像在腹部来源不明肿瘤诊断中的应用效果

目的:探讨64层螺旋CT三维成像在腹部来源不明肿瘤诊断中的应用效果。方法:采用回顾性、总结性研究方法，选择2014年6月到2018年2月在我院经手术病理证实的腹部来源不明肿瘤患者122例，术中病理诊断为良性肿瘤42例(良性组)和恶性肿瘤80例(恶性组)，所有患者都给予64层螺旋CT三维扫描与重建，记录影像学特征，判断诊断效果。结果:良性组与恶性组的CT图像质量主观评分分别为(3.89±0.45)分和(4.54±0.34)分，对比差异有统计学意义(P=0.018)。恶性组平扫期、动脉期、门脉期的CT值都显著高于良性组(P＜0.05)。在122例患者中，以CPR/MPR/VR/MIP显示肿瘤供血动脉100例，占比82.0%。恶性组中79例中显示供血动脉，良性肿瘤中21例显示供血动脉，对比差异有统计学意义(P＜0.05)。CT判断恶性肿瘤79例，良性肿瘤43例，对腹部来源不明肿瘤的诊断敏感性与特异性分别为98.8%和100.0%。结论:腹部肿瘤来源不同，特别增大时诊断困难；64层螺旋CT三维成像可立体、直观地显示肿瘤形态及与周围器官的关系，而且可以显示肿瘤血供，为手术提供可靠依据。

Application effects of 64-slice spiral CT three-dimensional in the diagnosis of unexplained tumor of abdomen

Objective:To investigate the effects of 64-slice spiral CT in the diagnosis of unexplained tumors of abdomen.Methods:Used a retrospective and summative study method,from June 2014 to February 2018,122 patients with unexplained tumors of abdomen confirmed by surgery and pathology were selected that included 42 patients of benign tumors (benign group) 80 patients of malignant tumors (malignant group) by the intraoperative pathological diagnosis.All patients were given 64-slice spiral CT three-dimensional scanning and reconstruction,recorded the imaging features,to determine the diagnostic effect.Results:The subjective scores of CT images in benign and malignant groups were (3.89±0.45) points and (4.54±0.34) points,respectively,and the difference was statistically significant (P=0.018).The CT values of the malignant group during the plain,arterial and portal phases were significantly higher than those in the benign group (P＜0.05).In the 122 patients,there were 100 patients of tumor blood supply artery indicated by CPR/MPR/VR/MIP that accounted for 82.0%.In the malignant group,the blood supply artery were shown in 79 patients,and the benign tumor showed the blood supply artery in 21 patients,and the difference was statistically significant (P＜0.05).There were CT diagnosed 79 patients of malignant tumors and 43 patients of benign tumors.The diagnostic sensitivity and specificity of the unexplained tumor of abdomen were 98.8%and 100.0%,respectively.Conclusion:Abdominal tumors have different sources,especially when it is difficult to diagnose.64-slice spiral CT three-dimensional imaging can stereoscopically and visually show the shape of the tumor and its relationship with surrounding organs,and can show the blood supply of the tumor,provide a reliable basis for surgery.