原发性肝癌多层面CT双动脉期与门静脉期增强扫描分析  

Multi-slices CT with double arterial phase and portal venous phase in detection of primary liver cancer

作　　者：江新青[1] 肖湘生[1] 谢琦[2] 吴红珍[2] 韦程纲[2] 陈明旺[2] 

机构地区：[1]第二军医大学附属长征医院放射科,上海200003 [2]广州医学院附属第一人民医院放射科,广东广州510180

出　　处：《中国中西医结合影像学杂志》2008年第2期84-87,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的：探讨原发性肝癌多层面CT（multi-slices CT,MSCT）双动脉期与门静脉期增强扫描各期强化特征及癌灶的检出率。方法：104例原发性肝癌治疗前行MSCT的平扫与三期扫描（双动脉期与门静脉期扫描）,对比剂用量100 ml,以3 ml/s的速率肘静脉注射,采集时间动脉早期20～22 s,动脉晚期34～37 s,门静脉期60 s。测病灶平扫及各增强期CT值,分析病灶的强化情况及检出情况,以增强各期检出的肿瘤数目为肿瘤灶总数。结果：三期增强扫描共显示470个病灶,34个均匀强化;436个不均匀强化,〈3 cm病灶动脉早期检出117个（56.25%）,动脉晚期检出171个（82.21%）,门静脉期检出137个（65.86%）,≥3 cm的病灶动脉早期检出237个（90.45%）,动脉晚期检出250个（95.41%）,门静脉期检出244个（93.12%）。56个仅在三期增强扫描的一期显示,动脉早期5个,动脉晚期25个,门静脉期26个。结论：动脉晚期的检出率明显高于门静脉期与动脉早期。双动脉期与门静脉期增强扫描有利于提高肝癌检出效率。Objective： To describe CT findings of primary liver cancer in double arterial phase and portal venous phase of multislices CT （MSCT） and evaluate their effect on detection of cancer lesions. Methods： One hundred and four patients with primary liver cancer were examined by abdominal plain CT and MSCT scanning at 20-22s （early arterial phase, EAP）, 35-37s （late arterial phase, LAP） and 60s （portal venous phase, PVP）. The CT density in hounsfield units of liver cancer were measured in every phase, and lesion detection and CT appearance were analyzed. Results： In three enhanced phase , 470 lesions were detected, of which 34 lesions demonstrated homogenous enhancement and 436 lesions inhomogenous enhanced. Detection rates were 56.25%, 82.21%, and 65.86% respectively in EAP, LAP and PVP for lesions less than 3 cm, and 90.45%, 95.41% and 93.12% respectively for lesions equal to or more than 3 cm. 56 lesions were seen only in one of contrast-enhanced imaging phase, including 5 lesions at EAP, 25 at LAP and 26 at PVP. Conclusion： The detection rate of LAP is higher than that of LAP and PVP. Tri-phase MSCT can improve detection and visualization of liver cancer.

关 键 词：肝癌 体层摄影术 X线计算机 对比剂 

分 类 号：R735.7[医药卫生—肿瘤] R816.5[医药卫生—临床医学]