Differential Diagnosis Analysis Of Recurrence And Post-Surgical Cavity Effusion After Hepatic Cystic Echinococcosis Surgery

Objective: To investigate the clinical value of ultrasound,CT examination and serological detection in differentiating post-surgical cavity effusion from recurrence after the operation of hepatic cystic echinococcosis.To evaluate different tests for the differential diagnosis and improve the prognosis of patients with the above two complications.Methods: From January 2008 to January 2017,41 patients who had hepatic cystic lesions found again after hepatic echinococcosis surgery treated in the first affiliated Hospital of Xinjiang Medical University were retrospectively analyzed.We collected the results of ultrasound,CT and serology of all patients,took the results of surgery/puncture as the diagnostic gold standard,the sensitivity,specificity,Youden’s statistics,positive likelihood ratio,negative likelihood ratio,positive predictive value and negative predictive value of different inspection methods were compared and ROC curve was drawn.Results:1.The area under the ROC curve(AUC)of ultrasound was 0.853,and the area under the ROC curve of CT examination was 0.664.2.The sensitivity of ultrasound in diagnosing recurrence was 84.21%,and the specificity was 86.36%.The positive likelihood ratio was 6.18,the negative likelihood ratio was 0.18,the positive predictive value was 84.21%,and the negative predictive value was 86.36%;The sensitivity of CT to the diagnosis of recurrence was 73.68%,and the specificity was 59.09%;The positive likelihood ratio was 1.80,the negative likelihood ratio was 0.45;The positive predictive value was 60.87%,and the negative predictive value was 72.22%;3.The sensitivity of ultrasound for the diagnosis of post-surgical cavity effusion was 86.36% and the specificity was 84.21 %;The positive likelihood ratio was 5.47,the negative likelihood ratio was 0.16;The positive predictive value was 86.36%,and the negative predictive value was 84.21%;The sensitivity of CT for the diagnosis of post-surgical cavity effusion was 59.09%,and the specificity was 73.68%;The positive likelihood ratio was 2.25,the negative likelihood ratio was 0.55;The positive predictive value was 72.22%,and the negative predictive value was 60.87%.Conclusion: In the differential diagnosis of post-surgical cavity effusion and recurrence after hepatic cystic echinococcosis surgery,the diagnostic value of ultrasound is better than CT,which has higher sensitivity and specificity,while serology is not significant in the differential diagnosis.