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目的观察和评价采用超声和CT鉴别诊断肝硬化再生结节和小肝癌的临床价值。方法制定纳入和排除标准,对2010年3月~2012年3月确诊为肝硬化门脉高压患者按自愿原则筛选78例,进行超声检查、CT平扫以及CT增强扫描,然后比较三者对肝硬化再生结节和小肝癌检出率的差别。结果超声检查、CT平扫和CT增强扫描在对肝硬化再生结节的诊断方面,三种检查手段检出率的差异无统计学意义(P>0.05)。超声检查和CT平扫在对肝硬化所并发的小肝癌的诊断方面,二者检出率的差异无统计学意义(P>0.05)。超声检查和CT增强扫描在对肝硬化所并发的小肝癌的诊断方面,二者检出率的差异具有统计学意义(P<0.05)。结论 CT增强扫描较超声检查和CT平扫在肝硬化并发小肝癌的诊断方面具有相对大的临床价值,而超声检查和CT平扫诊断水平差别不明显。在今后的临床实践中,CT增强扫描值得推广使用。
Objective To observe and evaluate the clinical value of differential diagnosis of liver cirrhosis nodules and small hepatocellular carcinoma by using ultrasound and CT. Methods To set inclusion and exclusion criteria, 78 cases of patients with cirrhosis and portal hypertension diagnosed by voluntarism from March 2010 to March 2012 were selected for ultrasound examination, CT scan and CT enhancement scan. Harmonic regeneration of nodules and small liver cancer detection rate difference. Results Ultrasonography, CT scan and CT enhanced scan in the diagnosis of cirrhosis nodules, the detection rate of the three methods showed no significant difference (P> 0.05). Ultrasonography and CT scan in the diagnosis of small hepatocellular carcinoma associated cirrhosis, the difference was not statistically significant (P> 0.05). Ultrasonography and CT enhanced scan in cirrhosis complicated by small liver cancer diagnosis, the difference between the two detection rates were statistically significant (P <0.05). Conclusions Compared with ultrasonography and CT plain CT in the diagnosis of liver cirrhosis and small hepatocellular carcinoma, CT enhanced scanning has relatively great clinical value. However, there is no obvious difference between CT and CT in the diagnosis of small hepatocellular carcinoma. In the future clinical practice, CT enhancement scan is worth promoting.