螺旋CT双期扫描对诊断小肝癌的应用价值  

Dual-phase spiral CT in diagnosis of small hepatic cell carcinoma

作　　者：王朝文[1] 谌力群[1] 黄晓萍[1] 黄小茹[1] 

机构地区：[1]广东省农垦中心医院放射科,广东湛江524002

出　　处：《右江民族医学院学报》2004年第2期177-179,共3页Journal of Youjiang Medical University for Nationalities

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评价。方法　对 2 3例拟诊小肝癌患者行螺旋CT动、静脉双期增强扫描 ,增强动脉期于造影剂注射后 3 0s开始扫描 ,静脉期于 60～ 70s开始扫描 ,造影剂注射速率为 3 .0ml/s ,用量 80～ 10 0ml。结果　 2 3例小肝癌共发现 2 8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 75 .0 0 %、93 .86%、82 .14 %、96.43 % ,动脉期和动静脉双期的检出率较平扫和静脉期高 (P <0 .0 5 ) ,动脉期和动静脉双期间 ,平扫和静脉期间比较差异无显著性 (P均 >0 .0 5 )。 71.43 % (2 0 /2 8)的小肝癌动脉期呈均匀高密度影 ,与同期肝组织比较 ,CT值增加 2 4.9± 13 .8Hu ;17.86% (5 /2 8)呈不均匀高密度影。 82 .14 % (2 3 /2 8)静脉期呈低密度影 ,与同期肝组织比较 ,CT值减少 13 .8± 8.5Hu ;17.86% (5 /2 8)为等密度影。双期扫描的定性准确率为 96.43 %。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 value of arterial-phase, portal venous- phase, and dual-phase spiral CT in diagnosis of small hepatic cell carcinoma (SHCC). Methods 23 patients early diagnosed as SHCC received arterial-, portal venous-and dual-phase spiral CT scans. The scans began at 30 seconds in arterial phase and at 60～70 seconds in portal venous phase after intravascular administration. The injection rate of contrast media was 3.0ml/s with a total of 80～100ml. Results 28 lesions were found in 23 patients. The detecting rates of lesions in non-contrast scanning (NC), arterial phase, portal venouse phase and dual phase were 75.00%, 93.86%, 82.14% and 96.43%, respectively. The sensitivity of arterial and dual phases were higher than those of NC and portal venous phases (P<0.05). There were no statistical differences between arterial phase and dual phase, NC and portal venous phase (all the P>0.05). 71.43% (20/28) of SHCC lesions showed homogeneous high attenuation with the enhancement of 24.9±13.8Hu in comparison to the liver tissues in the arterial phase, and 17.86% (5/28) of SHCC showed unhomogeneous high attenuation; 82.14% (23/28) of lesions in portal venous phase showed lower density than that of liver tissues in the same phase with the decreasing of 18.3±8.5Hu. 17.86% (5/28) of lesions showed the same density. The accurate diagnostic rate of dual phase was 96.43%. Conclusion Dual-phase spiral CT of liver is of high sensitivity and specificity in diagnosis of SHCC.

关 键 词：肝肿癌 体层摄影 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤]