CT多期增强扫描对微小肝癌的诊断价值研究  

Study on value of multi-phase enhanced CT scanning in the diagnosis of micro-hepatocellular carcinoma

作　　者：徐红文 XU Hong-wen(Department of Imaging,Jingjiang Second People's Hospital,Jingjiang 214500,China)

机构地区：[1]江苏靖江第二人民医院影像科,214500

出　　处：《中国实用医药》2023年第15期92-94,共3页China Practical Medicine

摘　　要：目的探讨CT多期增强扫描对微小肝癌的诊断价值。方法30例经临床确诊为微小肝癌的患者,均行上腹部平扫加增强三期扫描,对其CT增强扫描后病变的强化方式和影像表现进行回顾性分析。结果30例患者共检出35个病灶,其中29个病灶位于肝右叶,6个病灶位于肝左叶;24例为肝内首次发现微小肝癌,6例为肝癌治疗后肝内远处新生病灶。26例为单发结节,4例为多发结节;结节直径最大为1.0 cm,最小为0.7 cm,其中符合典型小肝癌速升速降(高-低-低)强化方式的结节有20例,呈(等-低-低)强化方式的有8例,呈(高-等-等)强化方式的2例,多数病灶动脉期的强化以不均匀弱到中等强化为主,病灶动脉期的边缘境界欠清,并未看到明显完整包膜形成,门脉延迟期边界均相对清晰。结论CT多期增强扫描由于扫描速度快、检查禁忌证相对较少的特点,能够充分反映出微小肝癌的血供特点和表现,使其早期诊断变为现实,可作为微小肝癌的重要临床诊断手段。Objective To discuss the value of multi-phase enhanced CT scanning in the diagnosis of micro-hepatocellular carcinoma.Methods 30 cases of micro-hepatocellular carcinoma diagnosed clinically were collected,and all underwent an upper abdominal plain scan plus enhanced three-phase scan,and the enhancement methods and imaging manifestations of their lesions after enhanced CT scanning were retrospectively analyzed.Results A total of 35 lesions were detected in 30 patients,29 of which were located in the right lobe of the liver and 6 in the left lobe of the liver.24 cases were the first detection of microscopic hepatocellular carcinoma in the liver,and 6 cases were distant de novo lesions in the liver after treatment of hepatocellular carcinoma.26 cases had single nodules,4 cases had multiple nodules,with a maximum diameter of 1.0 cm and a minimum diameter of 0.7 cm.Among them,20 cases had nodules in line with the typical small hepatocellular carcinoma rapid rise and rapid fall(high-low-low)enhancement mode,8 cases had nodules in line with(equal-low-low)enhancement mode,and 2 cases had nodules in line with(high-equal-equal)enhancement mode.Most of the lesions in the arterial phase had mainly heterogeneous weak to moderate intensification,and the border in the arterial phase was not clear,and the formation of complete envelope was not obvious,while the border in the delayed portal-venous phase was relatively clear.Conclusion Due to the characteristics of fast scanning speed and relatively few contraindications,multi-phase enhanced CT scanning can fully reflect the blood supply characteristics and manifestations of micro-hepatocellular carcinoma,which makes its early diagnosis a reality and can be used as an important clinical diagnostic tool for microscopic hepatocellular carcinoma.

关 键 词：CT 多期增强扫描 微小肝癌 

分 类 号：R735.7[医药卫生—肿瘤]