摘要
目的探讨甲胎蛋白(AFP)、癌胚抗原(CEA)联合多层螺旋CT(MSCT)扫描对肝胆管细胞癌(ICC)的诊断价值。方法收集2018年5月至2018年12月于我院就诊的48例ICC患者临床、病理及影像学资料,以术后病理检查结果为标准,比较不同检查方式对ICC诊断灵敏度和特异性,并总结ICC的相关影像特征。结果MSCT+AFP+CEA检查诊断ICC的灵敏度和特异性分别为95.83%和93.75%,均显著高于AFP、CEA、MSCT单独检查和AFP+CEA检查(P<0.05)。CT平扫中所有病灶平扫可见圆形、分叶状或多结节融合的边界不清低密度影,其中肿块或结节型32例,局部浸润病变型10例和弥漫浸润型6例。32例肿块或结节型病灶边可表现为分叶状或菜花样,有8例病灶周围见环形更低密度影,4例病灶所在肝叶萎缩,相邻肝包膜凹陷,形成所谓的"癌脐"征象。35例病灶远端可见胆管扩张,并呈圆形或藤条状边缘锐利的低密度影。4例病灶在动脉期呈现轻度强化,且呈边缘环状强化,其中有12例肿块或结节型病灶内部呈网格状、片絮状强化。42例病灶在静脉期呈渐进性延迟强化,强化程度及范围高于动脉期,在延迟期所有病灶均强化,呈"慢进慢出"的特点。结论MSCT可直观显示肿瘤病灶大小、位置以及转移等情况,联合多项肿瘤标志物共同检测对诊断ICC有更高的灵敏度和特异性。
Objective To investigate the diagnostic value of alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA)combined with multi-slice spiral CT(MSCT)scan for intrahepatic cholangiocarcinoma(ICC).Methods The clinical pathology and imaging data of 48 ICC patients who were treated in our hospital from May 2018 to December 2018 were collected.The results of postoperative pathological examination were used as a standard to compare the sensitivity and specificity of different examinations for ICC,and to summarize the relevant imaging features of ICC.Results The sensitivity and specificity of MSCT+AFP+CEA examination in the diagnosis of ICC were 95.83%and 93.75%,respectively,which were significantly higher than those of AFP,CEA,MSCT alone and of AFP+CEA(P<0.05).In the plain scan of CT,all the lesions showed lowdensity shadow with obscure boundary,which were round,lobulated or multi-nodular confluent.Among them,32 cases were mass or nodular type,10 cases were local invasive type and 6 cases were diffuse infiltrated type.The edge of lesions of 32 cases that were mass or nodular type was lobulated or like cauliflower.In which,there were 8 lesions with lower density shadows like the ring around it,and 4 lesions.In 4 lesions,the hepatic lobe of was atrophied,and the adjacent hepatic envelope was depressed,forming a socalled"cancer umbilical"sign.There were 35 cases whose distal end of lesions can be seen with cholangiectasis,showing round or rattan-like low-density shadow with sharpe edge.There were 4 lesions showed mild enhancement in the arterial phase,and showed marginal enhancement like ring.There were 12 lesions were mass or nodular type showed gridlike,patch-like enhancement inside it.There were 42 lesions showed progressive delayed enhancement in the venous phase.The degree and extent of enhancement were higher than that in the arterial phase.All lesions were enhanced in the delayed phase,showing a characteristic of"slow-in and slow-out".Conclusion MSCT can visually demonstrated the size,location and metastasis of tumor lesi
作者
陈永芊
张德军
敬文斌
CHEN Yong-qi;ZHANG De-jun;JING Wen-bin(Department of Radiology,Deyang Second People's Hospital,Deyang 618000,Sichuan Province,China)
出处
《中国CT和MRI杂志》
2020年第8期83-85,共3页
Chinese Journal of CT and MRI
关键词
甲胎蛋白
癌胚抗原
多层螺旋CT
Alpha-fetoprotein
Carcinoembryonic Antigen
Multi-slice Spiral CT
Diagnostic Value
