Abstract:Objective: To evaluate the diagnostic value of CT detection in the diagnosis of patients with liver cirrhosis by referring to liver biopsypathological diagnosis. Methods: A total of 102 patients with chronic hepatitis B (CHB) admitted to the hospital from March 2018 to March 2019 were selected as the subjects. All of them underwent ultrasound-guided liver biopsy and CT detection. With the results of ultrasound-guided liver biopsy as the golden standard, the diagnostic value of CT detection in patients with liver cirrhosis was evaluated. Results: With the results of liver biopsy pathological diagnosis as the golden standard, the sensitivity, specificity, accuracy and Kappa value of CT detection for liver cirrhosis were 89.23% (58/65), 78.38% (29/37), 85.29% (87/102) and 0.680, respectively.Among the 65 patients with liver cirrhosis confirmed by liver biopsy pathology, CT found that 47.69%had abnormal liver morphology (including hepatic fissure widening and stiffness of liver surface contour), 49.23% had decreased liver CT value lower than that of the same level spleen, 40.00% had abnormal ratio of left to right liver lobe, 38.46% had portal vein outer diameter and spleen vein outer diameter widening, and 63.08% had splenomegaly. The overall coincidence rate of CT detection with liver biopsy pathological diagnosis for grade of liver function was 87.69%. CT signs of benign nodules of liver cirrhosis showed no obvious enhancement signal, but CT of malignant nodules showed a fast-in and fast-out enhancement mode, and the lesions became larger and more in a short time. Conclusion: CT detection is consistent with liver biopsy pathological diagnosis for early diagnosis of liver cirrhosis, evaluation of the severity and differential diagnosis of benign and malignant nodules. It may be an effective means for the diagnosis of liver cirrhosis.
[1] 袁博,李欢送.血栓弹力图在肝硬化脾切除术后预防门静脉血栓中的应用[J].河北医学,2018,24(1):83~86. [2] 郭津生.肝纤维化研究热点及进展-2019年视点[J].中华肝脏病杂志,2019,27(6):401~402. [3] 中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2015年版)[J].泸州医学院学报,2016,39(1):1~20. [4] Luca,Rinaldi,Fabio,et al.Clinical features and natural history of cryptogenic cirrhosis compared to hepatitis C virus-related cirrhosis[J].World Journal of Gastroenterology,2017,23(8):1458~1468. [5] Li L,Duan M,Chen W,et al.The spleen in liver cirrhosis:revisiting an old enemy with novel targets[J].Journal of Translational Medicine,2017,15(1):111. [6] 秦敏. 慢性乙型肝炎肝硬化FibroScan测量结果与肝穿刺病理的关系[J].肝脏,2019,15(6):674~676. [7] LiuS,Sheng H,Shi H,et al.Computed tomography portography of patients with cirrhosis with normal body mass index:Comparison between low-tube-voltage CT with low contrast agent dose and conventional CT[J].Medicine,2018,97(48):131~141. [8] 王辉,刘晓晶.CT检查与病理诊断早期肝炎后肝硬化的临床价值分析[J].影像研究与医学应用,2017,1(3):93~94. [9] 张海涛.多层螺旋CT平扫及三期动态增强扫描对肝细胞癌的诊断价值研究[J].中国CT和MRI杂志,2018,24(7):86~88.