对比增强超声与增强CT对诊断肝癌病灶大小可靠性的对比研究

目的 探讨对比增强超声（CEUS）与增强CT（CECT）对中肝癌（最大径3.0～5.0 cm）与非中肝癌（最大径＜3.0 cm或＞5.0 cm）病灶大小诊断的可靠性。方法 回顾性分析2013年6月至2016年6月我院收治的手术并经病理组织学证实的肝癌患者197例，患者均为单发病灶，分为中肝癌组96例和非中肝癌组101例。患者均行CEUS与CECT检查。采用χ2检验比较CEUS与CECT在不同病灶大小肝癌诊断中的差异。结果 CEUS与CECT诊断197例肝癌病灶大小的受试者工作特征（ROC）曲线下面积分别为0.774和0.706，差异无统计学意义（P＞0.05）。96例中肝癌组中，CEUS诊断的特异度为80.6％～85.8％，灵敏度为73.2％～91.6％；CECT诊断的特异度为65.1％～77.2％，灵敏度为63.2％～85.3％。101例非中肝癌组中，CEUS与CECT的诊断准确率分别为92.1%和91.1%，差异无统计学意义（P＞0.05）；96例中肝癌检查组中，两种方法检查的诊断准确率分别为97.9%和89.6%，差异有统计学意义（P＜0.05）。结论 对于肝癌病灶大小的测量尤其是中肝癌，术前优先选择CEUS具有更高的应用价值。

Comparative study of CEUS and CECT in the diagnosis of liver cancer lesion size

Objective To investigate the diagnostic value of contrast enhanced ultrasound（CEUS） and contrast enhanced X-ray computed tomography（CECT） in the diagnosis of hepatocellular carcinoma with different tumor sizes. Methods The data of 197 cases of hepatocellular carcinoma of our hospital from June 2013 to June 2016 were analyzed retrospectively. The nidus of all patients were single，in which the maximum diameter was 3.0-5.0 cm as medium hepatocellular carcinoma group（A）， and the others was in non medium hepatocellular carcinoma group（B）. CEUS and CECT were done in all the 197 patients, including 96 patients in group A, and the other 101 patients in group B. The χ2 test was used to compare the CEUS and CECT in the diagnosis of hepatocellular carcinoma with different sizes. ResultsThe area under the curve of CEUS and CECT in the 197 cases were 0.774 and 0.706 respectively， whose difference was not statistically significant（P＞0.05）. However， in group A， the specificity by CEUS was 80.6％-85.8％， and the sensitivity was 73.2％-91.6％；while the specificity by CECT was 65.1％-77.2％， and the sensitivity was 63.2％-85.3％. The accuracy rates of CEUS and CECT in group B were 92.1% and 91.1%（P＞0.05）. The accuracy rates of CEUS and CECT in group A were 97.9% and 89.6%（P＜0.05）. Conclusion For the measurement of the size of liver cancer lesions, especially in the liver cancer patients with medium size liver lessions, preoperative selection of CEUS has higher application value.