64层螺旋CT多期扫描双动脉期诊断小肝癌的价值探讨  

Small Hepatocellular Carcinoma：Evaluation of 64-slice Spiral CT Contrast-Enhanced Double Arterial Phase

作　　者：丁建林[1] 易旦冰[2] 陈晓亮[1] 陈耀强[1] 

机构地区：[1]广东医学院附属深圳福田人民医院深圳市第四人民医院放射科,广东深圳518033 [2]广东医学院附属深圳福田人民医院深圳市第四人民医院手术室,广东深圳518033

出　　处：《实用放射学杂志》2009年第4期505-508,共4页Journal of Practical Radiology

基　　金：深圳市福田区公益性科研项目（编号：FTWS077）.

摘　　要：目的评估64层螺旋CT双动脉期扫描对小肝癌的诊断价值。方法23例（25个病灶）小肝癌患者，经64层螺旋CT双动脉期、门静脉期三期增强扫描。采用对比剂追踪触发技术启动动脉早期扫描，触发监测点设为腹腔干层面的降主动脉，触发阈值140Hu，触发后延迟5S开始动脉早期扫描，延迟20S开始动脉晚期扫描，动脉早期与动脉晚期扫描分别屏气进行；门静脉期扫描用固定的延迟70s；每次全肝扫描的时间为4～5s。测量各期病灶与肝脏（同层面肝实质）的密度差值（取CT值差值的绝对值）；分析与统计动脉早期、动脉晚期及门静脉期对病灶的检出率。结果动脉早期及动脉晚期病灶与肝脏密度差值的差异有显著统计学意义（P〈0．01）；动脉早期检出率（11个，44．0％）低于动脉晚期（19个，76．0％）；双动脉期加门静脉期检出率（25个，100％）高于动脉晚期加门静脉期（21个，84．0％）及动脉早期加门静脉期（15个，60．0％）。结论64层螺旋CT双动脉期及门静脉期多期扫描提高对多血供小肝癌的检出率。Objective To investigate the value of 64-slice spiral CT contrast-enhanced double arterial phase in diagnosis of small hepatocellular carcinoma（SHCC）. Methods 23 patients （25 lesions） with SHCC underwent contrast-enhanced 64-slice helical CT examinations,including double arterial phases and portal phase. The early arterial phases were initiated by automatic bolus tracking 5 s delay after triggering at a threshold of 140 HU in the aorta at the origin of the celiac arteries and initiation scanning of the late arteries phase 20 s delay after triggering. The early arterial phase or late arterial phase was performed respectively in a single breath-hold, the portal venous phase stared at the 70th second after the injection of contrast medium, four to five seconds every time of whole liver scan. The CT values between the liver and SHCC were measured. The detectable rates of SHCC in every phase were analyzed statistically. Results The CT values in the liver and SHCC were different significantly in the early arterial phase and late arterial phase（P〈0.01）. The detectable rates of the lesions in early arterial phase（44.0%） was lower than that in late arterial phase （76.0%） ,the detectable rate of the lesions with double arterial phases in combination with portal venous phase was the highest （100%） compared with the late arterial phase combined with the portal venous phase and the early arterial phase combined with the portal venous phase（84.0% and 60.0 % ,respeetively）. Conclusion 64- slice spiral CT multiphase enhanced scans can improve the detecting rate of SHCC.

关 键 词：盱脏 肝细胞癌 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]