104在非典型影像學表現之小型肝結節中，利用洗除表現來預測肝癌之可能性
論文分類:
碩士論文
學號:
P0130002
姓名:
江明峯
指導教授:
花國鋒
畢業日期:
2016-08-01
摘要:
前言：由於早期肝癌血流模式的確立，理論上在肝癌成長上washout appearance應在arterial enhancement之前發生，並且對於未成熟血流動力特徵之早期肝癌之偵測上可能佔有較重要之角色。 研究方法：在2005年10月至2015年8月間，此研究共收集277位病患及461個小於2.0公分的腫瘤。所有的腫瘤皆不符合Li-RADs (v.2014)及AASLD (2010)肝癌影像學診斷指引的條件（在斷層掃描或磁振造影中同時符合arterial phase enhancement (AE)及portovenous phase washout appearance (WA)）。利用肝臟切片檢查做確立診斷。 結果：收錄的腫瘤大小介於0.4至2.0公分間。在461個肝腫瘤中238個（51.6%）為肝癌，其中76.9%為分化良好肝癌。單純WA及單純AE的敏感度及特異性分別為39.1%和76.2%以及17.6%和87.0%。單變數迴歸分析顯示腫瘤大小(OR 1.684 (95%CI 1.127-2.516), p= 0.011)及WA (OR= 1.755 (95%CI 1.252-2.49), p<0.001)皆有統計上之差異。但是單變數分析發現只有WA顯示統計上之差異(p<0.001)，而AE則無差異(p=0.055)。 結論：在不具典型肝癌影像學特性之小型肝腫瘤的診斷上，Portovenous phase washout appearance比arterial phase enhancement更有臨床上預測的效益。
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