CT在肝细胞癌与肝胆管细胞癌鉴别诊断中应用.docVIP

CT在肝细胞癌与肝胆管细胞癌鉴别诊断中应用 　　[摘要]目的 研究分析CT诊断在鉴别肝细胞癌与肝胆管细胞癌中的临床应用价值。方法 选取我院2013年4月～2017年6月收治的40例肝细胞癌患者作为肝细胞癌组，选取同期收治的40例肝胆管细胞癌患者作为肝胆管细胞癌组，对两组患者均进行CT扫描诊断，观察两组患者的临床扫描结果。结果 肝胆管细胞癌组患者经增强扫描发现的动脉期、门脉期延迟强化率高于肝细胞癌组，差异有统计学意义（P0.05）；肝胆管细胞癌患者的病灶最大直径明显短于肝胆管细胞癌患者，差异有统计学意义（P0.05）；两组患者的HBsAg阳性、肝硬化、AFP升高、合并结石及淋巴转移等影像学表现比较，差异有统计学意义（P0.05）。结论 临床上通过CT增强扫描技术能够对肝细胞癌、肝胆管细胞癌的供血程度和组织来源进行准确地把握，是对原发性肝癌患者的一种有效鉴别诊断方法。 　　[关键词]CT诊断；肝细胞癌；肝胆管细胞癌；诊断价值 　　[中图分类号] R735.7 [文献标识码] A [文章编号] 1674-4721（2017）12（a）-0142-03 　　[Abstract]Objective To study and analyze the clinical application value of CT in the differential diagnosis of hepatocellular carcinoma and hepatic cholangiocarcinoma.Methods From April 2013 to June 2017，40 patients with hepatocellular carcinoma （HCC） admitted into our hospital were enrolled as the HCC group，and 40 patients with hepatic cholangiocarcinoma treated in the same period were selected as the hepatic cholangiocarcinoma group.CT scan were applied in both groups，and the clinical outcomes of scanning were observed.Results The delayed enhancement rates of arterial and portal venous phases in the hepatic cholangiocarcinoma group were significantly higher than those of the HCC group，with statistical significance （P0.05）.The maximum diameter of the lesions in patients with hepatic cholangiocarcinoma was greatly smaller than that in HCC patients （P0.05）.The imaging manifestations of HBsAg positivity，liver cirrhosis，AFP elevation，complicated gallstone，and lymphatic metastasis in the two groups were displayed statistically significant in the two groups （P0.05）.Conclusion In clinic，enhanced CT scanning can accurately show the degree of blood supply and tissue-derived of HCC and hepatic cholangiocarcinoma，which is an effective differential diagnostic method for the patients with primary liver cancer. 　　[Key words]CT diagnosis；Hepatocellular carcinoma；Hepatic cholangiocarcinoma；Diagnostic value 　　肝?K原发性细胞癌主要包括肝细胞癌、肝胆管细胞癌和两种癌结合性癌，其中肝细胞癌的临床发病率最高，占90%左右，而肝胆管细胞癌则占5%左右[1]。原发性细胞癌患者初期临床症状并不十分明显，临