DTLPCT、DSA和CDFI对小肝癌早期诊断价值的研究  

Research on Value of Early Diagnosis of Small Hepatocellular Carcinoma by Joint Examination Consisting of DTLPCT. DSA and CDFI

作　　者：于志坚[1] 咸爱莲[1] 茅国新[1] 沈丰[1] 李小彦[1] 于嘉伟[1] 

机构地区：[1]南通医学院附属医院,江苏省南通市226001

出　　处：《中国临床医学》1999年第2期177-180,共4页Chinese Journal of Clinical Medicine

摘　　要：目的：提高对肝内小占位性病变诊断的敏感性和特异性。方法：采用CDFI初筛，结合DSA、DTLPCT等项特殊检查，对肝癌病危人群、干部体检和普通B超所发现各种良恶性肝内≤3cm小结节进行联合检测，发现48例SHCC，并与50例肝硬化结节、炎性肉芽肿或腺瘤样增生等良性病变进行对照。结果：CDFI可见两组血流信号、多项血流参数等均有显著差异。DSA检查，80％SHCC可见特征性肿瘤血管和肿瘤染色。LPCT反DTLPCT对SHCC检测率高达94．7％，直径最小仅2～3mm。DTLPCT除可见癌灶内碘油进一步聚集增浓外，其周边及子灶部分显示更为完整。并提出SHCC大体可分成包膜完拉和不完整两种类型，其临床表现、Child分级、生物学行为和预后等均有很大差异。结论：上述多种方法联合检测，可起到互补和提高早期诊断水平的作用。objective: To raise the sensitivity and specificity in diagnosis of small intrahepatic space occupying lesion. Methods: In those from high risk group of liver cancer, cadres given physical examination and common outpatients, various small intrahepatic benign or malignant nodules, which were found to be from 2 to 3 cm in diameter by ordinary B - mode ultrasonography, were jointly detected by using first screening by CDFI in combination with special examining metbods of DSA and DTLPCT. Forty - eight of those patients were found to have been ill with SHCC which were compared with benign foci of cirrhosis nodules, inflammatory granuloma and adenomatous hyperplasia from 50 patients of the control group. Results: By way of CDFI, the signals of blood flows could be seen in the experimental and control groups, and there was a significant diference in most of paramters of blood flow between the two groups. On examination through DSA, characteristic tumor vessels and tumor stain were seen in 80 per cent of patients with small hepatocellular carcinomas. The detectable rate of SHCC obtained by LPCT and DTLPCT was as high as 94. 7 per cent, with the smallest nodules being only from 2 to 3 mm in diameter.DTLPCT showed not only a more dense lipiodol concentration with in carcinomatous foci, but also a more completeness of its perifocal location and daughter foci. In our opinion, small hepatocellular carcinomas may be classified into two types: the one with complete integument and the one with incomplete integument, which have a great difference in clinical manifestations,child - pugh, biological behavior, and prognosis of disease. Conclusions: The joint use of the above methods in examination will play a complementary role, thus raising the level in early diagnosis of small hepatocellular carcinoma.

关 键 词：CT DSA 小肝癌 早期诊断 彩超 碘化油 

分 类 号：R735.704[医药卫生—肿瘤]