320层螺旋CT动态增强扫描对影像学表现不典型转移性肝癌的诊断价值  

Value of 320-slice dynamic contrast enhanced spiral CT in diagnosis of metastatic liver cancer with atypical CT manifestations

作　　者：徐凡[1] 郭媛[1] 吴梅[1] 吴红珍[1] 江新青[1] 孔庆聪[2] 

机构地区：[1]广州市第一人民医院放射科,510180 [2]中山大学附属第三医院放射科,广州510630

出　　处：《中华肝脏外科手术学电子杂志》2015年第2期35-38,共4页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：国家自然科学基金(81302550);广州市医药卫生科技项目(201102A213105)

摘　　要：目的探讨320层螺旋CT在影像学表现不典型的转移性肝癌诊断中的临床价值。方法回顾性分析2010年8月至2014年8月在广州市第一人民医院行320层螺旋CT平扫和增强扫描,并经病理学检查确诊的62例CT表现不典型转移性肝癌患者临床资料。其中男45例,女17例;年龄37～83岁,中位年龄63岁。所有患者均签署知情同意书,符合医学伦理学规定。观察320层螺旋CT平扫和增强扫描病灶的显像特点,包括病灶的密度、数目、边界、增强方式。结果 62例不典型转移性肝癌CT平扫,94%（58/62）表现为低或稍低密度,6%（4/62）表现为高低混杂密度;病灶多发型占77%（48/62）,单发型占23%（14/62）;边界模糊占79%（49/62）,边界清晰占21%（13/62）。CT增强扫描渐进性强化型占50%（31/62）,无明显强化型占21%（13/62）,边缘花环样强化型占11%（7/62）,快进快出型占5%（3/62）,多种强化方式混合型占13%（8/62）。结论采用320层螺旋CT动态增强扫描可以较好地评估影像学表现不典型转移性肝癌的组织学和血供特征,为临床治疗方案的制定提供更为准确的影像学依据。Objective To investigate the clinical value of 320-slice spiral CT in diagnosis of metastatic liver cancer with atypical CT manifestations. Methods Clinical data of 62 patients with metastatic liver cancer with atypical CT manifestations who were confirmed by the pathological examination and underwent 320-slice CT plain scan and enhanced scan in the First People＇s Hospital of Guangzhou from August 2010 to August 2014 were studied retrospectively. Of the 62 patients, 45 were males and 17 were females with the age ranging from 37 to 83 years old and the median of 63 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The imaging characteristics of the lesions by spiral CT plain scan and enhanced scan were observed, including density, number, boundary and enhancement pattern of the lesions. Results On CT plain scan of the 62 cases, 94%（58/62） displayed low or slightly low density and 6%（4/62） displayed mixed high and low density, 77%（48/62） were with multiple lesions and 23%（14/62） were with single lesion; 79%（49/62） were with obscureboundary and 21%（13/62） were with well-defined boundary. On CT enhanced scan, 50%（31/62） were with progressive enhancement, 21%（13/62） were without obvious enhancement, 11%（7/62） were with wreathlike edge enhancement, 5%（3/62） were with fast in fast out enhancement and 13%（8/62） were with multiple patterns enhancement. Conclusions 320-slice dynamic contrast enhanced spiral CT may better reflect the histological and blood supply characteristics of metastatic liver cancer with atypical imaging manifestations and provide more accurate imaging evidences for the formulation of clinical therapeutic regimen.

关 键 词：肝肿瘤 肿瘤转移 体层摄影术 螺旋计算机 X线影像增强 

分 类 号：R735.7[医药卫生—肿瘤]