螺旋CT三期增强扫描肝细胞癌不典型表现16例的临床分析  

Atypical appearances of hepatocellular carcinoma on triple-phase spiral CT enhancement （a report of 16 cases）

作　　者：谢品超[1] 叶文钦[1] 文康彦[1] 练旭辉[1] 梁权海[1] 陈忠[1] 

机构地区：[1]南方医科大学附属新会医院放射科,江门529100

出　　处：《国际医药卫生导报》2010年第18期2226-2229,共4页International Medicine and Health Guidance News

摘　　要：目的 探讨肝细胞癌（hepatocellular carcinoma,HCC）在螺旋CT三期增强扫描的不典型表现,提高HCC的诊断正确率.方法 16例HCC患者平扫后行螺旋CT三期增强扫描,造影剂注射速率为3.0 ml/s,然后开始肝动脉期、门静脉期和延迟期扫描,观察病灶的强化方式.结果 7例肝动脉期边缘有环形或点状强化,门静脉期强化程度和范围较动脉期大,延迟期强化范围进一步扩大,表现出延迟强化.4例肝动脉期边缘部呈不规则环形强化,门静脉期和延迟期此强化环呈等密度,内见壁结节影.2例肝动脉期呈高密度,门静脉期和延迟期呈等密度.3例三期增强扫描始终无明显强化表现,呈低密度.结论 HCC在螺旋CT三期增强扫描不典型强化方式是HCC的病理基础和生长方式所造成的.Objective To explore the atypical appearances of hepatocellular carcinoma （HCC）on triple-phase spiral CT enhancement,and to improve the accuracy rate of HCC diagnosis. Methods The pre-and post-contrast CT scanning of the entire liver in 16 patients with HCC was performed by a spiral CT scanner. The contrast material was infused at a rate of 3.0ml/s,followed by sequential arterial,portal venous,and delayed phase scans of the liver. The pattern of all lesions enhanced in each phase was observed. Results Seven of the 16 patients showed ring-like or dot-like enhancement margin on arterial phase （AP）,enhancement level and area were more and more extent during portal venous phase （PVP） and delayed phase （DP）,and they showed delayed enhancement. 4 cases showed irregular ring-like enhancement margin on AP. The enhanced ring-like showed isodense during PVP and DP and muralnodules were seen. Two patients showed hyperdense on AP and isodense during PVP and DP. Three patients did not obviously enhance during triple-phase and showed hypodense. Conclusions The basicpathological and the growth mode of HCC is the main cause of the atypical CT enhanced findings.

关 键 词：肝细胞癌 计算机 X-线体层摄影 诊断显像 

分 类 号：R735[医药卫生—肿瘤] R730[医药卫生—临床医学]