小肝癌螺旋CT双期增强扫描动脉期价值探讨  

Evsluation of the arterial phase of biphase enhanced SCT in the diagnosis of small HCC

作　　者：周康荣[1] 严福华[1] 涂备武[1] 

机构地区：[1]上海医科大学附属中山医院放射科,200032

出　　处：《中华肝脏病杂志》1999年第3期135-137,共3页Chinese Journal of Hepatology

摘　　要：目的评估螺旋ＣＴ（ＳＣＴ）双期增强扫描动脉期的临床价值和限度，探讨肝动脉期的意义，起始、结束和持续时间。方法收集３组经手术病理证实的小肝细胞癌（ＨＣＣ）病例，Ａ组４９例５３个病灶，Ｂ组１４８例，１８６个病灶，Ｃ组５２例５２个病灶，均行ＳＣＴ双期动态增强扫描，Ｃ组另行病灶层面动脉期同层动态扫描。统计和分析双期病灶检出率，定性准确性，动脉期病灶强化情况，测定动脉期开始、结束和持续时间等。结果Ａ组５３个病灶动脉期的检出率为８８．６８％，双期为９０５７％，明显高于超声。在Ａ、Ｂ组中，动脉期病灶显著强化的比例为７６％和７８％。根据同层动态扫描测得的肝动脉期开始、结束和持续时间（平均）分别为１６、９秒，３９．６秒和２２．７秒。结论螺旋ＣＴ双期动态扫描尤其是动脉期扫描对小肝癌的诊断价值很高。因动脉期持续时间短，充分理解和严格掌握动脉期的扫描期相十分重要。Objective To evaluate the value of the arterial phase (AP) of biphase enhanced SCT inthe diagnosis of small HCC and investigate the criteria, initial time, ending time and duration of APMethods From May 1995 to March 1999, patients with small HCC proved by surgicopathology including49 cases (N=53) in the Ist group, 148 cases (N=186) in the 2nd group and 52 cases (N=52)n in the 3rdgroup were collected. Biphase dynamic enhanced SCT scans were performed in all patients of three groupsand additional single-level dynamic scans only done in the 3rd group. The detectability, diagnostic accuracy of the lesions and enhancement of the lesion in AP were analyzed statistically. In addition, the Antialtime, ending time and duration of AP were measured. Results The results of the lst group showed thedetectability of small HCC was 88.68% in AP and 90.57% in both ptiases, higher than those by US.Markedly enhanced lesion in AP accounted for 76% and 78% in the 2nd and 3rd groups resistively. TheAntial, ending and duration times of AP measured on safe--level dynamic scans were 16.gs, 39.6s and 22.7sin average respectively. Conclusion The biphase dynamic SCT espeially its arterial phase appears to bevery valuable in diagnosiflg small HCCs. In light of short duration of AP, understandiflg and strict controlof AP is obviously imperative.

关 键 词：螺旋CT 小肝癌 诊断 肝肿瘤 

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