螺旋CT双期扫描对小肝癌的诊断价值  

Evaluation of Dual-phase Spiral CT in Diagnosis of Small Hepatic Cell Carcinoma

作　　者：李玉梅[1] 罗祖炎[1] 吴颖[1] 卢建芳[1] 毕玉艳[1] 刘子江[1] 

机构地区：[1]浙江省人民医院放射科,浙江杭州310014

出　　处：《实用放射学杂志》2001年第6期440-442,共3页Journal of Practical Radiology

摘　　要：目的　评价螺旋CT扫描的动脉期、静脉期以及双期联合应用对小肝癌的诊断价值。方法　对 2 7例小肝癌行螺旋CT双期增强扫描 ,增强动脉期于造影剂注射后 2 5～ 30s开始扫描 ,静脉期于 6 5～ 70s开始扫描 ,造影剂注射速率为 2 .5～ 3.0ml/s,用量 70～ 85ml。结果　 2 7例小肝癌共发现 34个结节病灶。平扫、动脉期、静脉期、动静脉双期的检出率分别为 70 %、91%、79%、94% ,经统计学分析 ,动脉期和动静脉双期的检出率较平扫和静脉期高 (Ρ <0 .0 5 ) ,动脉期和动静脉双期间、平扫和静脉期间比较均无统计学意义 (Ρ >0 .0 5 )。 6 5 % (2 2 / 34 )的小肝癌动脉期呈均匀高密度 ,与同期肝组织比较 ,CT值平均增加 2 5 .9± 14.4HU ;2 3%(8/ 34 )呈不均匀高密度。 79%静脉期呈低密度 ,与同期肝组织比较 ,CT值平均减少 18.7± 8.9HU ;2 1% (7/ 34 )为等密度。双期扫描的定性准确率为 97% (31/ 32 )。结论　螺旋CT动、静脉双期扫描对小肝癌诊断有很高的敏感性和特异性。Objective To evaluate the diagnostic value of dual-phase spiral CT in diagnosis of small hepatic cell carcinoma(SHCC).Methods Dual-phase spiral CT was performed in 27 patients with SHCC(≤3 cm).The scans began at 25-30 s arterial phase and at 65～70 s in portal venous phase after intravascular atministration.The injection rate of contrast media was 2.5 ml/s with a total of 70～85 ml. Results 34 lesions were found in 27 patients.The detecting rate of lesions on non-contrast scanning,arterial phase,portal venous phase and dual phase were 70%,91%,79%,94% respectively.The sensitivity of arterial and dual phase were higher than that of non-contrast scanning(NC)and portal venous phase(Ρ<0.05).There was no significant difference found between NC and portal venous phase(Ρ>0.05),arterial phase and dual phase(Ρ>0.05) 65% of SHCC lesions showed homogeneous high attenuation with the enhancement of 25.9±14.4 HU compared with the liver tissue on the arterial phase,and 23% of SHCC showed unhomogeneous high attenuation,79% of lesions on portal venous phase showed lower density than that of liver tissue on the same phase with the decreasing of 18.7±8.9 HU,21% of lesions showed the same density.The accurate rate of diagnosis of dual-phase was 97%.Conclusion Dual-phase spiral CT of liver is of high sensitivity and specificity in diagnosis of SHCC.

关 键 词：小肝癌 X线计算机体层摄影 螺旋CT 双期扫描 诊断 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学]