原发性小肝细胞癌的CT增强扫描血供特点  

The Characteristic of Blood Supply of the Small Hepatic Carcinoma in Enhanced CT

作　　者：李家德[1] 

机构地区：[1]山东省临沂市人民医院影像科,山东临沂276003

出　　处：《社区医学杂志》2008年第3期3-4,共2页Journal Of Community Medicine

摘　　要：目的观察原发性小肝细胞癌的血供特点，提高CT对小肝细胞癌的定性诊断能力。方法观察34例经手术病理证实的原发性小肝细胞癌患者，采用肝动脉、门静脉及静脉期扫描，扫描时间分别选择于注入造影剂后28～30s、65～70s及180s。造影剂注射速率为3．0ml／s，用量90～100ml。结果共发现37个结节病灶。平扫、动脉期、门静脉期、静脉期的检出率分别为75.6％、94.6％、97．3％、81.1％，动脉期和门静脉双期的检出率较平扫和静脉期高（P〈0．05），动脉期与门静脉期、平扫与静脉期检出率无显著性差异（P均〉0．05）。34例中28例肝癌组织为单纯肝动脉供血型，其中动脉期强化密度明显高于正常肝脏22例，边缘轻度高密度6例；6例为肝动脉和门静脉双重供血型，其中4例在三期扫描过程表现为“向心性”强化。结论原发性小肝细胞癌由肝动脉供血者占绝对优势；部分可见肝动脉和门静脉双重供血，并呈现“向心性”强化征象，需与肝脏血管瘤鉴别。Objective To observe the blood supply of the small hepatic carcinoma（SHC）. Methods 34 cases with SHC which were approved by pathology or operation were observed. We used single dynamic spiral CT scan in arterial - phase, portal vein - phase and vein - phase. Twenty - eight to thirty seconds, sixty - five to seventy seconds and one hundred and eighty seconds after injection（at the 3.0 ml/s, 90 -100 ml） , scanning started. The radiographic features were analyzed. Results 34 cases of SHC were detected, including 37 lesions. The detecting coefficient in routine scan, arterial - phase, portal vein - phase and vein - phase were 75.6% , 94.6% , 97.3%, 81.1% respectively. The lesion was easier to find in arterial -phase and portal vein - phase than in routine scan and vein - phase （ P 〈 0.05 ）. There was no obvious difference comparing arterial -phase and portal vein- phase and routine scan and vein- phase（P 〉0.05 ）. During 34 cases, there were 28 cases that were supplied only by artery, 6 cases by artery and portal vein. Conclusion Primary SHC was mainly blood supplied by liver artery, partly by artery and portal vein. It showed centripetal sign.

关 键 词：小肝细胞癌 原发性 肿瘤血供 螺旋CT 三期扫描 

分 类 号：R814.42[医药卫生—影像医学与核医学]