64排CT对肝硬化背景下小肝癌的诊断价值  

Small Hepatocellular Carcinoma in Patient with Cirrhotic Background：Diagnosis with 64-slice Spiral CT

作　　者：丁伟伟[1] 郭玉林[2] 牛建栋[1] 黄婷婷[1] 蔡磊[2] 陈勇[2] 闫少宁[2] 侯登华[2] 朱凯[2] 

机构地区：[1]宁夏医科大学研究生院,宁夏银川750004 [2]宁夏医科大学附属医院放射科,宁夏银川750004

出　　处：《实用放射学杂志》2011年第5期736-739,共4页Journal of Practical Radiology

摘　　要：目的 探讨64排CT三期扫描在肝硬化背景下小肝癌（small hepatocellular carcinoma,SHCC）诊断中的价值.方法 回顾性分析57例肝硬化背景下小肝癌患者的CT图像,采用双源64排螺旋CT机（SIEMENS）,扫描参数：120 kV,270～300 ms,层厚7 mm,螺距3;平扫后增强三期扫描,分别为：动脉期（注射对比剂后25～30 s）、门脉期（注射对比剂后50～60 s）及延时期（注射对比剂后120～180 s）扫描.图像由2名副主任医师或以上水平的影像学专家在不知晓病理结果的情况下,各自独立分析SHCC各时相表现,分别确定肿瘤病灶数目、大小和强化特点,如2人意见不同时可进行讨论,直至2人意见相同.数据采用χ2检验.结果 57例患者共发现70个病灶,动脉期、门脉期和延时期检出率分别为92.9%、75.7%和81.4%,三期两两比较有统计学差异（P＜0.05）.结论 SHCC动脉期检出率最高,定性诊断主要依据增强的动态变化特点,CT三期扫描可提高SHCC诊断和鉴别诊断能力.Objective To evaluate the value of 64-slice CT in diagnosis of small hepatocellular carcinoma（SHCC） in patient with cirrhotic background. Methods CT images of 57 patients with SHCC in cirrhosis. Multiphase contrast-enhanced CT was performed by using a 64-section CT scanner. Scan parameters were：kV= 120, ms： 270--300;slice thickness 7 mm, pitch 3. Multiphase included arterial phase, portal venous phase and delayed phase after contrast media injection 25 -- 30 s, 50-- 60 s and 120-- 180 s, respectively. The images were analysed by two physicians to define the number, size, enhanced features of the tumors independently. When the results were inconsistent,it could be discussed until consistence. The data were dealed with Z2 test. Results 70 lesions were detected in 57 patients by CT. The detecting rates of the lesions by arterial phase,portal venous phase and delayed phase were 92.9% ,75.7% and 81.4% respectively,there were significant differences （P〈0.05） among three phases. Conclusion The detecting rate of SHCC is highest by arterial phase in comparison with portal venous phase and delayed phase. Muhiphase CT can improve the ability of diagnosis and differential diagnosis of SHCC.

关 键 词：肝脏 肝硬化 肝癌 体层摄影术 X线计算机 

分 类 号：R575.2[医药卫生—消化系统] R735.7[医药卫生—内科学]