16层螺旋CT双动脉期扫描对小肝癌的诊断价值  

Value of double arterial phase multi-slice helical CT in diagnosis of small hepatocellular carcinoma

作　　者：王文献[1] 文利[1] 刘卫金[1] 梁开运[1] 邹利光[1] 

机构地区：[1]第三军医大学新桥医院放射科,重庆400037

出　　处：《第三军医大学学报》2006年第1期12-14,共3页Journal of Third Military Medical University

摘　　要：目的 评价多排螺旋CT（multidetector row helical CT，MDCT）双动脉期扫描对小肝癌的诊断价值。方法 回顾性分析经临床和病理证实的22例、共26个病灶的小肝癌临床和影像学资料；扫描采用美国GE lightspeed plus 16层螺旋CT进行检查，增强扫描采用3～4期（动脉早期和晚期、门脉期、平衡期或延迟期），动脉早期为20s，动脉晚期为30s，门脉期：55～65s，平衡期：100～120s，延迟期为5min，每个全肝扫描周期为8．2s；扫描结束后在工作站对图像进行处理，选定病灶、正常肝组织区为兴趣区（region of inlerest，ROI），对同一ROI分别在不同的时相上测量、对比和计算。结果 病灶位于肝左叶10例，肝右叶16例。26个病灶单纯动脉早期呈高密度者7个，平均CT值为（62．3±14．6）Hu，检出率为26．9％；单纯动脉晚期呈高密度者18个，平均CT值为（87．9±16．6）Hu，检出率为69．2％；双动脉期显示高密度的病灶25个，检出率为96．2％；门脉期显示低密度病灶19个，检出率达73．1％。26个病灶中在动脉早期表现为高密度，门脉期为低密度的病灶数有7个，检出率为26．9％。在动脉晚期表现为高密度，门脉期为低密度的病灶数有17个，平均CT值为（56．2±13．6）Hu，检出率为65．4％，门脉期显示高密度病灶4个，平均CT值为（82．9±17．8）Hu，检出率为15．4％。结论 MDCT双动脉期扫描，能较大的提高小肝癌的检出率。Objective To explore the value of muhidetector row helical CT （MDCT） in diagnosing small hepatocellular carcinoma. Methods Twenty-two cases of small hepatocellular carcinoma （26 lesions） verified by clinic and pathology were analyzed retrospectively. GE lightspeed plus 16 CT was used, enhancement scaned with three to four phases： early artery phase （delay 20 s）, late artery phase （delay 30 s）, portal vein phases （delay 55 -65 s）, equilibrium phase （delay 100 -120 s）, and delay phase （delay 5 min）. The whole liver was scaned in 8.2 s. The images were processed at workstation, including selecting lesion and normal liver as regions of interest （ROIs） , and measuring, comparing, and calculating the same ROI at different phases. Resuits Ten lesions located in left lobule, 16 in right lobule. Of all the 26 lesions, 7 appeared as high density at early artery phase with mean CT value （62.3 ± 14.6） Hu and detective ratio of 26.9% , 18 appeared as high density at late artery phase with mean CT value （87. 9 ± 16. 6） Hu and detective ratio of 69. 2%, 25 （96.2%） appeared as high density in double-arterial phases. Seventeen （65.4%） appeared as low density at portal vein phases with mean CT value （56.2 ± 13.6） Hu, 4 （ 15.4% ） appeared as high density at portal vein phase with mean CT value （82.9 ± 17.8） Hu. Conclusion MDCT double-arterial phase scan can markedly improve the detection rate of small hepatocellular carcinoma.

关 键 词：肝肿瘤 体层摄影术 X线计算机 

分 类 号：R730.44[医药卫生—肿瘤] R735.7[医药卫生—临床医学]