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肝包膜凹陷征在邻表面肝脏恶性肿瘤诊断中的价值研究
作者:孙延豹  王军燕  方春  黄益镌  吴凡  温晓伟 
单位:1. 嘉兴市第一医院放射科  浙江 嘉兴 314000 
2.
 浙江中医药大学附属嘉兴市中医医院放射科  浙江 嘉兴 314000 
3.
 嘉兴市第一医院病理科  浙江 嘉兴 314000 
关键词:胆管肿瘤/放射摄影术 肝肿瘤/放射摄影术 诊断 鉴别 体层摄影术 X线计算机 磁共振成像 回顾性研究 
DOI:R735.8;R730.44
出版年,卷(期):页码:2015,30(4):356-359
摘要:
目的 探讨肝包膜凹陷征(liver capsule depressed,LCD)的形成原因及其在肝脏邻表面病变诊断中的价值。方法 经病理证实的178例邻表面肝脏病变的患者均接受CT平扫检查,158例经CT平扫+多期增强扫描,128例同时还接受磁共振增强检查。结果 85例良性肿瘤,出现LCD征象4例(4.7%),93例恶性肿瘤,出现LCD征象21例(22.6%)。恶性肿瘤中,外周型胆管细胞癌发生率最高(66.7%,14/21)。LCD征象对诊断邻表面肝脏恶性肿瘤的敏感度、特异性、阳性预测值、阴性预测值、准确度分别为22.6%、95.3%、84.0%、52.9%、57.3%(χ2=12.020,P<0.05)。LCD征象对诊断邻表面胆管细胞癌的敏感度、特异性、阳性预测值、阴性预测值、准确度分别为56.0%、92.8%、56.0%、92.8%、87.6%(χ2=2.121,P<0.05)。结论 LCD在区分良、恶性肿瘤,特别是在胆管细胞癌与其他肿瘤的鉴别诊断中有一定的价值。
Objective To evaluate the application of liver capsule depressed (LCD) sign in the diagnosis of malignant liver tumors on adjacent surface. Methods One-hundred-and-seventy-eight patients with liver lesions confirmed by pathology underwent CT scan, with 158 cases receiving contrast-enhanced CT scan and 128 cases undergoing contrastenhanced MRI scan simultaneously. Results Among 178 patients, 4 out of 85 benign tumors, and 21 out of 93 malignant tumors had LCD sign, in which 66.7%(14/21) were intrahepatic peripheral cholangiocarcinoma. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LCD sign in the diagnosis of malignant liver tumors on adjacent surface were 22.6%, 95.3%, 84.0%, 52.9%, 57.3%, respectively (χ2=12.020, P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LCD sign in the diagnosis of cholangiocarcinoma on adjacent surface were 56.0%, 92.8%, 56.0%, 92.8%, 87.6%, respectively (χ2=2.121, P<0.05). Conclusion LCD sign is a characteristic sign of liver lesions on adjacent surface, which may be of value in the differential diagnosis of benign and malignant tumors particularly for cholangiocarcinoma.
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