CTHA和CTAP联合碘油漂注对肝硬化结节性质判断的应用价值  

The Clinical Value of CTHA,CTAP and Lp-CT in the Diagnosis of Hepatic Cirrhosis Nodules

作　　者：杜超 朱西琪 

机构地区：[1]南京第二医院,南京210003

出　　处：《中国现代医生》2009年第7期5-7,25,共4页China Modern Doctor

摘　　要：目的探讨螺旋CT扫描在肝动脉造影CT(CTHA)和经动脉门脉造影CT(CTAP)联合碘油CT在肝硬化结节性质判断中的应用价值。方法分析30例临床诊断为肝硬化、超声发现异常回声结节病例的CTAP、CTHA及碘油CT(Lp-CT)图像,并与肝脏多期增强扫描进行对照。结果直径为2.1～3.0cm、1.1～2.0cm、≤1.0cm的病灶,多期增强CT检出率分别为94.4%、75.0%和41.7%,CTHA的病灶检出率分别为100.0%、90.0%和75.0%,CTAP病灶检出率分别为100.0%,95.0%和83.3%;CTAP和CTHA均可出现假阳性改变,其灌注异常出现率分别为12.0%和19.1%;部分微小癌灶靠CTAP和CTHA无法检出,仅在Lp-CT上显示为小点状的碘油沉积。结论CTAP和CTHA结合分析能提高小肝癌的检出率,对0.5cm以下的病灶,Lp-CT检出率高于CTAP和CTHA。Objective To evaluate the significance of spiral CT hepatic arteriography（CTHA）, CT arterial portography （CTAP） and Lipi- odol-CT（Lp-CT）in diagnosis of small liver cirrhosis nodules. Methods The CTHA, CTAP and Lp-CT manifestations of 30 small liver nodular lesion confirmed by ultrasound from patients with liver cirrhosis were analyzed and compared with those in multi-phase enhanced CT. Results The detection rate of multi-phase enhanced CT,CTHA and CTAP was 94.4% ,100.0% and 100.0% respectively to the nodules of 2.1-3.0cm in diameter,and 75.0%,90.0%,95.0% to the nodules of 1.1-2.0cm in diameter,and 41.7%,75.0%,83.3% to the nodules not more than 1.0cm in diameter. Both CTHA and CTAP gave false positive findings,perfusions defects was 19.1% and 12.0% respectively. A little minute liver cirrohsis nodules have no positive findings in CTHA/CTAP but appearance a punctiform lipiodol deposition in Lp-CT. Conclusion CTHA/CTAP techniques can increase the sensitivity of diagnosis for small liver nodules which is very helpful in findings of small hepatocellular carcinoma. Lp-CT is superior to detect fiver nodules which diameter not more than 0.5cm.

关 键 词：动脉性门脉造影 肝动脉造影 计算机体层摄影 肝硬化结节 

分 类 号：R575.2[医药卫生—消化系统]