螺旋CT三期增强扫描对富血管结节型肝细胞癌的诊断价值  

The value of triphasic contrast-enhanced spiral CT scanning in the diagnosis of hypervascular nodular hepatocellular carcinoma

作　　者：肖运平[1] 梁斌[2] 肖恩华[2] 

机构地区：[1]广西医科大学第五附属医院柳州市人民医院放射科,广西柳州545006 [2]中南大学湘雅二医院放射科

出　　处：《实用放射学杂志》2011年第11期1673-1676,共4页Journal of Practical Radiology

基　　金：基金项目：广西壮族自治区卫生厅科研课题（Z2008411.Z2009310）;湖南省自然科学基金（06JJ20081）;广疆柳州市应用技术研究与开发计划课题（2010030718）.

摘　　要：目的探讨螺旋CTi期增强扫描对富血管结节型肝细胞癌（hepatocellularcarcinonla．HCC）的诊断价值。方法收榘动脉期呈均一强化的40例40个局灶性肝脏病变的动态CT图像，试验组包括21个富血管结节型HCC病灶。对照组包括11个快速填充型肝血管瘤（hepaticcavernoushemangioma．HCH）、4个局灶性结节增生（focalnodularhyperplasia，FNH）、2个孤立性肝转移瘤和2个肝细胞腺瘤（hepatocellularadenonla，HCA），4位放射科医师分别对去除了延迟期的肝脏CT双期（动脉期＋门脉期）扫描图像和三期扫描图像进行回顾性识读．采用受试者操作特征（ROC）曲线评价2组扫捕方式对结节趔HCC的诊断价值。结果对富脏管结节型HCC的诊断，双期扫描组的平均ROCfI}I线下面积为0．7915±0．0217，增加了延迟期的i期扫描组的ROL、曲线下面积为0．9088±0．0107，两者差异有统计学意义（t＝－10．452，P＝0．002）。结论补充了延迟期的CT三期增强扫捕有助于进一步显示富血管结节型HCC的强化特征，提高其诊断效能。Objective To investigate the value of triphasic contrast-enhanced spiral CT scanning in the diagnosis of hypervacular nodular hepatocellular carcinoma （ HCC）. Methods 40 cases with 40 focal hepatic lesions manifesting homogeneous enhancement at the arterial phase of dynamic CT scanning were included in the study. 40 lesions comprised 21 hypervascular nodular HCCs, 11 rap idly filling hepatic cavernous hemangiomas （HCH） , 4 focal nodular hyperplasias （FNH）, 2 solitary hepatic metastases and 2 hepa tocellular adenomas （HCA）. Dual phase CT scanning excluding delayed phase and triple-phase CT scanning images in 40 patients were reviewed independently by 4 radiologists. The diagnostic efficiency of the two types of CT scanning were statistically analyzed with receiver operating characteristic （ROC） curve. Results In the diagnosis of hypervascular nodular HCC, the mean area under ROC curve in dual phase scanning group was 0. 7915±0. 0217, and that in triple phase scanning group including delayed phase was 0. 9088±0. 0107. There was significant difference between the two CT scanning groups （ P= 0. 002 ）. Conclusion The addition of delayed phase to dual-phase CT scanning can improve the enhancement characteristics of hypervascular nodular HCC, which is of value in its diagnosis.

关 键 词：肝脏 体层摄影术 X线计算机 肝细胞癌 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]