64排MDCT检查中不同浓度碘对比剂对高龄肝硬化肝癌患者诊断价值与安全性  

Diagnostic value and safety of different iodine concentrations of contrast agents in 64-slice MDCT check in elderly liver cirrhosis patients with liver cancer

作　　者：唐啸[1] 程若勤[1] 简纪华[1] 

机构地区：[1]武汉科技大学附属天佑医院放射科,湖北武汉430064

出　　处：《中国临床研究》2017年第8期1039-1042,共4页Chinese Journal of Clinical Research

摘　　要：目的探究不同浓度碘对比剂在64排多排螺旋CT(MDCT)中对高龄肝硬化肝癌患者的诊断价值与安全性。方法选取2014年1月至2015年12月收治的80例高龄肝硬化肝癌患者,采用随机数字表法将患者均分为A组和B组,每组40例,两组患者均行平扫和增强扫描,A组使用370 mg I/ml的优维显增强,B组使用300 mg I/ml的优维显增强,均注射100 ml,注射速度均为3.0 ml/s。测量两组患者增强肝实质、主动脉、门静脉的CT值,并统计两组患者病灶检出结果和两组患者不良反应发生情况。结果 A组患者增强后的肝实质CT值在门脉期、延迟期均明显高于B组(P均<0.05),A组主动脉CT值在动脉期明显高于B组(P<0.05),A组门静脉CT值在门脉期、延迟期均明显高于B组(P均<0.05);80例患者检出肝癌病灶236个,所有病灶动脉期和门脉期的诊断敏感性A组高于B组(P<0.05);两组患者的不良反应总发生率无统计学差异(P>0.05)。结论在高龄肝硬化肝癌患者的MDCT扫描中,高浓度对比剂在肝实质、主动脉、门静脉中能产生更高的CT值,且高浓度对比剂在动脉期和门脉期亦能提高肝癌的检出率,安全性与低浓度对比剂相似。Objective To evaluate the diagnostic value and safety of different iodine-concentrations of contrast agent in the check of 64-multi-detector computed tomography（ MDCT） for elderly liver cirrhosis patients with liver cancer. Methods Eighty elderly liver cirrhosis patients with liver cancer treated between January 2014 and December 2015 were selected and divided into group A and group B（ n = 40,each） according to random number table method. Both plain scan and enhanced scan were performed in two groups. For enhanced CT scan,370 mg I/ml Ultravist and 300 mg I/ml Ultravist were respectively used with a injection rate of 3. 0 ml/s and a injection volume of 100 ml in group A and group B. The CT values（ HU） of enhanced scan for hepatic parenchyma,aorta and portal vein were measured,and statistics of lesion detection results and adverse reactions were made in two groups. Results After enhancement,the CT values of liver parenchyma in portal phases and delayed phases in group A were significantly higher than those in group B（ all P〈0. 05）; the CT value of aorta in arterial phase in group A was significantly higher than that in group B（ P〈0. 05）. The CT values of portal vein in portal phases and delayed phases in group A were all significantly higher than those in group B（ all P〈0. 05）. A total of236 foci of liver cancer were detected in 80 cases. The sensitivity in detecting all lesions in arterial phase and portal phase in group A was statistically higher than that in group B（ P〈0. 05）. Conclusion In MDCT scan of elderly liver cirrhosis patients with liver cancer,high concentration of contrast agent can produce the higher CT values in hepatic parenchyma,aorta and portal vein and increase the detection rate of liver cancer in arterial phase and portal phase. The safety is similar to that of low concentration of contrast agent.

关 键 词：对比剂碘浓度 多排螺旋CT 肝硬化肝癌 诊断价值 

分 类 号：R735.7[医药卫生—肿瘤] R575.2[医药卫生—临床医学]