螺旋CT双期增强扫描对小肝癌的诊断价值  

The diagnostic value of the helical CT dual-phase enhancement in small hepatocellular carcinoma

作　　者：郑可国[1] 沈静娴[1] 赵志清[1] 许达生[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080

出　　处：《影像诊断与介入放射学》2004年第4期207-211,共5页Diagnostic Imaging & Interventional Radiology

基　　金：广东省卫生厅研究基金资助(A1998173)

摘　　要：目的研究螺旋CT双期增强扫描小肝癌的CT表现。方法分析经病理证实的小肝癌115例共122个病灶的螺旋CT双期增强扫描的CT表现。结果①平扫瘤内密度均匀者有93个病灶,瘤内密度不均匀者有29个病灶;增强后瘤内密度均匀者只有54个病灶,瘤内密度不均匀者有68个病灶。②平扫病灶边界清楚者有42个病灶,边界模糊者有80个病灶;增强后病灶边界清楚者有85个病灶,边界模糊者只有37个病灶。③双期增强扫描瘤灶的强化形式有:①76个病灶动脉期呈全瘤均匀性或不均匀性强化,门脉期病灶的强化密度迅速下降至低于或等于肝实质;②19个病灶动脉期病灶呈边缘性环形强化,强化环不完整,环壁厚薄不一并有壁结节,门脉期强化环的密度降至低于或等于肝实质;③27个病灶动脉期和门脉期强化密度都低于肝实质。结论小肝癌螺旋CT双期增强扫描的CT表现具有一定的特点,根据此特点可以与肝脏其他病变鉴别。Objective To study the helical CT dual-phase enhancement features of small hepatocellular carcinoma (SHCC). Methods The helical CT dual-phase enhancement features of SHCC were analyzed in 115 cases with 122 lesions, all the lesions were confirmed by histopathology. Results ⑴In unenhanced scan, there were uniform density in 93 lesions, and there were uneven density in 29 lesions; In enhanced scan, there were uniform density just in 54 lesions, and there were uneven density in 68 lesions. ⑵In unenhanced scans, 42 lesions had clear borders, and 80 lesions had obscure borders; In enhanced scan, 85 lesions had clear borders, and just 37 lesions still had obscure borders. ⑶The enhancement patterns of the lesions during dual-phase scan include follows: ①76 lesions manifested homogenous or heterogeneous enhancement in the whole lesions in hepatic arterial phase, and the density of the lesions was decreased quickly to hypodense or isodense than the hepatic parenchyma in portal venous phase. ②Nineteen lesions manifested peripheral enhancement in the border of the lesions in hepatic arterial phase. The enhancement ring wasn't intact, and the thickness of the enhancement ring wasn't uniform. In the portal venous phase, the density of the enhancement ring was decreased quickly to hypodense or isodense than the hepatic parenchyma. ③Twenty-seven lesions manifested hypodense than the hepatic parenchyma both in hepatic arterial phase and in portal venous phase. Conclusion The helical CT dual-phase feature of SHCC is characteristic, and SHCC might be distinguished from other hepatic diseases.

关 键 词：病灶 增强扫描 小肝癌 螺旋CT 动脉期 门脉 肝实质 壁厚 不均匀性 边界 

分 类 号：R735.7[医药卫生—肿瘤]