Doppler超声和CT在肝癌定性诊断中的对照研究

本文对１０２例（共１１９个）均经手术及／或病理证实的肝内实质占位进行了Ｄｏｐｐｌｅｒ超声（ＣＤＦＩ和ＰＤ）与ＣＴ的对照研究。其中，原发性肝癌６９例（７５个病灶），转移性肝癌５例（６个病灶），肝海绵状血管瘤２２例（３０个病灶），其它病变６例（８个病灶）。结果表明Ｄｏｐｐｌｅｒ（ＣＤＦＩ＋ＰＤ）与常规超声相结合，则其对肝癌定性诊断的特异性（９７．２２％）显著高于ＣＴ诊断的特异性（７１．４５％），同时亦显著高于常规超声特异性（６６．６７％），因而认为Ｄｏｐｐｌｅｒ超声在肝癌定性诊断的特异性方面优于ＣＴ。研究还发现ＣＴ的特异性较低主要是由于≤３ｃｍ组的特异性较低所致。另外，Ｄｏｐｐｌｅｒ超声对肝癌定性诊断的敏感性（９５．１８％）亦高于ＣＴ（９０．１２％），但统计学上无显著性差异（Ｐ＞０．０５），而其准确性（９５．８０％）却显著高于ＣＴ（８４．４８％）（Ｐ＜０．０５），因此Ｄｏｐｐｌｅｒ超声为肝癌诊断提供了一个新的手段。

Doppler Ultrasound Study Compared with CT for the Diagnosis or Liver Cancer

One hundred and nighteen hepatic solid lesions (102 cases), which confirmed by operation and histopathology, were studied using Doppler ultrasound technique (Color Doppler Flow Imaging and Pulsed Doppler) compared with Computed Tomography, including 69 cases (75 lesions) were primary liver cancer, 5 cases (6 lesions) metastatic liver cancer, 22 cases (30 lesions) hepatic cavernous hemangioma and 6 cases (8 lesions) others. The results showed that specificity(97.22%) of Doppler ultrasound combined with the conventional sonography was much more higher than that of computed tomography (71.45%) and conventional sonography for the diagnosis of liver cancer, and the lower specificity of CTwas due to lower specificity for the group of less than 3 cm lesions. Moreover, the sensitivity of the Doppler sonography (95.18%) was also higher than that of CT (90.12%) for the diagnosis of liver cancer, but there was not statistically difference between them (P>0.05), and its accuracy (95.80%)was remarkably higher than that of CT(84.38%) (P<0.05). Therefore, Doppler ultrasound can be regarded as a new means for the diagnosis of liver cancer.