MSCT多时相薄层扫描对微小肝癌的诊断  

Diagnosis of microhepatic cellular carcinoma using multi-phase helical CT

作　　者：陈文军[1] 程明[1] 王恩锋[1] 赵新宇[1] 王春颖[1] 赵军[2] 

机构地区：[1]武警黑龙江总队医院CT室,150076 [2]哈尔滨医科大学附属肿瘤医院放疗科

出　　处：《中国CT和MRI杂志》2006年第4期52-53,共2页Chinese Journal of CT and MRI

摘　　要：目的研究多层螺旋CT(MSCT)多时相薄层扫描对微小肝癌(MHCC)的诊断价值。方法临床已确诊为肝功能失代偿期的肝硬化患者300例,每6个月行MSCT动脉期(20～25s)、门静脉期(50～55s)、平衡期(2～3min)多时相薄层(3～5mm)扫描,CT检查阳性病例均行DSA选择性肝动脉造影检查。结果300例肝功能失代偿期肝硬化患者中共检出MHCC27例,其MSCT表现特点是平扫呈等密度或略低密度,动脉期呈高密度,门静脉期呈略高密度、等密度或略低密度,平衡期呈等密度或低密度。敏感性分别为:动脉期为92.59%(25/27),门静脉期为77.78%(21/27),平衡期为88.89%(23/27),综合多时相薄层扫描敏感性为96.30%(26/27)。DSA检出MHCC的敏感性为33.33%(9/27)。27例MHCC患者中,25例经穿刺活检或手术病理证实,1例AFP明显增高(409μg/L),1例8个月后发展成巨块型肝癌,1年后死亡。结论MSCT多时相薄层扫描检出MHCC癌灶以动脉期和平衡期为最佳,综合多时相薄层扫描影像可明显提高MHCC的检出率和诊断正确率。Objective To study diagnostic value of multi-slice helical computed tomography (MSCT) over microhepatic cellular carcinoma (MHCC). Methods 300 patients who had been clinically confirmed as cirrhosis in decompensation phase underwent scans ever six months using MSCT(3～5 mm) at hepatic arterial-phase (HAP) (20～25s), portal venous-phase (PVP()50～55s)and delayed-phase (DP) (2～3min)scanning. All patients that had been proved diseased by CT underwent DSA. Results 25 MHCC patients were detected in all the 300 patients, displaying iso- or slightly hypointensity on plain scan, hyperintensity on HAP, slightly hyperintensity, iso- or slightly hypointensity on PVP, iso- or hypointensity on DP. The sensitivity was 92.59%(25/27), 77.78%(21/27)and 88.89%(23/27)and 96.30%(26/ 27)for HAP, PVP, DP and overall MSCT , respectively. Sensitivity of DSA in detecting MHCC was 33.33%(9/27). Among 27 MHCC patients, 25 were confirmed by puncture biopsy or surgical pathology. 1 case had significantly increased AFP(409Hg/L). One patient developed massive type hepatic cancer. Conclusion MSCT can best detect MHCC at HAP and DP.

关 键 词：微小肝癌 肝硬化 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R735.7[医药卫生—放射医学]