肝肿瘤的双期动态CT诊断  

Hepatic Tumors:Dual-phase Dynamic CT Diagnosis

作　　者：言伟强[1,2] 李常茂[1,2] 范承经 唐绍心[1,2] 

机构地区：[1]湖南医科大学附属第二医院放射科 [2]昆明医学院附属第二医院放射科

出　　处：《实用放射学杂志》1998年第9期520-523,共4页Journal of Practical Radiology

摘　　要：目的：探讨双期动态ＣＴ对肝肿瘤诊断的价值。方法：４８例肝肿瘤患者平扫发现并定位病灶后，用压力注射器以３ｍｌ／ｓ速度从肘静脉经１７号塑料套管针注入造影剂６０ｍｌ，开始注射后１４ｓ行双期动态ＣＴ，同层共扫７次。结果：本方法对原发肝癌、肝血管瘤和肝转移癌的定性诊断准确性分别为９５．７％、１００％和８０％，均明显高于普通增强ＣＴ（Ｐ＜０．０５）。原发肝癌的典型表现是动脉期病灶内结节状、片状强化，并可见肿瘤血管影，强化部分在静脉期迅速呈低密度影；肝血管瘤的特征性表现为动脉期病灶边缘结节状强化，密度类似于主动脉或肝动脉，静脉期强化结节逐渐向病灶中央扩展；肝转移癌的主要表现为动、静脉期病灶边缘环状强化，中央部分无明显强化，静脉期还可见到“牛眼征”。结论：双期动态ＣＴ能获取肝肿瘤的特征性表现。Objective:To evaluate the value in diagnosing hepatic tumors with dual-phase dynamic CT.Methods:Dual-phase dynamic CT scans were done in 48 patients after contrast-enhanced scan.By using a power injector,60 ml of 75% contrast material was injected at a speed of 3 ml/sec via a 17-guage antecubital vein catheter,14 s after start of bolus the dual-phase dynamic CT scans were performed 7 times at the single level.Results:The accurate diagnostic rates of primary hepatocellular carcinoma(PHC),hepatic cavernous hemangioma(HCH) and hepatic metastasis (HM)with dual phase dynamic CT were 95.7%、100% and 80%respectively,it was supernior those of conventional contrast enhanced CT scan(p<0.05).The typical manifestations of PHC were nodular,irregular and heterogenous enhanced regions in lesion,tumorous vessels could be seen in the arterial phase,the hyperdense regions in the arterial phases were changed to hpodense quickly in the portal phase;The characteristic findings of HCH were well-defined intense mural nodular enhancement in the arterial phase,and centripetally oriented enlargement of this nodular in the portal phase,the density of the nodular in the arterial phase were similar to that of aorta or hepatic arteries.The features of HM were continuous ring enhancement in both the arterial and the portal phase,'bull eye sign'could be seen in some patients.Conclusion:The characteristic findings of hepatic tumors can be showed by dual-phase dynamic CT scan,so it may be as a means of studing hepatic tumors,it offer a very useful method in study of those lesions.

关 键 词：肝肿瘤 诊断 CT 双期动态CT 

分 类 号：R735.704[医药卫生—肿瘤] R730.44[医药卫生—临床医学]