探讨CT值在原发性肝癌（肝癌）肝周淋巴结转移中的诊断价值。

回顾性分析2001年10月至2015年1月在上海交通大学医学院附属新华医院行肝癌切除+淋巴结清扫术的14例患者临床资料。所有患者均签署知情同意书，符合医学伦理学规定。其中男8例，女6例；年龄36～73岁，中位年龄51岁。14例患者经术前增强扫描检查发现15组淋巴结可疑阳性，根据术后病理学检查分为阳性组（8组）和阴性组（7组）。比较两组淋巴结平扫、动脉期CT值及动脉期CT值变异系数（CV）的差异等，并分析上述指标诊断淋巴结转移的准确率。两组观察指标比较采用t检验，诊断淋巴结转移的准确率分析采用受试者工作特征（ROC）曲线。

阳性组平扫CT值、动脉期CT值及其CV分别为（30±4）HU、（45±10）HU、（30±10）%，阴性组相应为（43±5）HU、（65±18）HU、（17±6）%，两组差异有统计学意义（t=-5.400，-2.660，2.990；P<0.05）。ROC曲线分析显示平扫CT值、动脉期CT值及其CV诊断分界值分别为38 HU、54 HU及22%，诊断准确率分别为100%、80%、80%。

CT值定量分析对肝癌肝周淋巴结转移具有诊断价值。当肝周淋巴结平扫CT值<38 HU、动脉期CT值<54 HU、动脉期CT值CV>22%时，提示转移可能性大。

To explore the diagnostic value of computed tomography (CT) value for perihepatic lymph node metastasis of primary liver cancer (PLC).

Clinical data of 14 patients undergoing PLC resection + lymph node dissection in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between October 2001 and January 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among the patients, 8 were males and 6 were females with the age ranging from 36 to 73 years old and the median of 51 years old. Fifteen groups of suspicious positive lymph nodes of the 14 patients were detected by enhanced CT scan before operation, and were divided into the positive group (n=8) and the negative group (n=7) according to the postoperative pathological examination. The differences in plain CT value, arterial phase CT value and coefficient of variation (CV) of arterial phase CT value of the lymph nodes between two groups were compared. And the diagnostic accuracy of the lymph node metastasis by these indexes was analyzed. The observation indexes of two groups were compared using t test and the analysis on the diagnostic accuracy of lymph node metastasis was conducted using receiver operating characteristic (ROC) curve.

The plain CT value, arterial phase CT value and CV of arterial phase CT value were respectively (30±4) HU, (45±10) HU and (30±10)% in the positive group, and were respectively (43±5) HU, (65±18) HU and (17±6)% in the negative group, and significant differences were observed between two groups (t=-5.400, -2.660, 2.990; P<0.05). ROC curve analysis showed that the cut-off value of plain CT value, arterial phase CT value and CV of arterial phase CT value was respectively 38 HU, 54 HU and 22%, and the diagnostic accuracy was respectively 100%, 80% and 80%.

CT value has certain diagnostic value for perihepatic lymph node metastasis of PLC. Perihepatic lymph node metastasis is likely to occur when plain CT value<38 HU, arterial phase CT value<54 HU and CV of arterial phase CT value>22%.