多排CT对肝细胞癌动门脉分流诊断能力研究  

Diagnostic capability of multidetector CT for arterioportal shunt in hepatocelluar carcinoma

作　　者：罗明月[1] 单鸿[1] 姜在波[1] 李露芳[1] 黄惠卿[1] 张建生[1] 

机构地区：[1]中山大学附属第三医院放射科,广州510630

出　　处：《中华肿瘤杂志》2004年第4期231-233,共3页Chinese Journal of Oncology

摘　　要：目的　评价多排CT(MDCT)技术诊断肝细胞癌 (HCC)合并动门脉分流 (APS)的能力。方法　 2 82例HCC接受MDCT肝动脉早期、晚期和门脉期薄层增强扫描和数字减影血管造影 (DSA)检查。APS的诊断标准 :(1)门脉主干和 (或 ) 1级分支增强早于肠系膜上静脉或脾静脉 ,或门脉主干和(或 ) 1级分支显影密度大于肠系膜上静脉或脾静脉 ;(2 )门脉 2级及以下分支增强早于门脉主干 ,或门脉 2级及以下分支显影密度大于门脉主干。采用双盲法分析、比较MDCT和DSA显示APS的结果。结果　全组有 5 6例HCC合并APS。MDCT显示中央型APS 4 8例 ,其中重度 4 1例 ,中度 7例 ,有 1例HCC病灶巨大 ,DSA未能显示合并的中度分流 ;轻度周围型APS 7例 ,有 2例因分流量小DSA未能显示。 1例中度混合型APSMDCT和DSA均显示。结论　MDCT是一种简便、有效、非侵入性诊断HCC合并APS的新技术。Objective To evaluate the capability of multidetector CT(MDCT) for the diagnosis of arterioportal shunt(APS) associated with hepatocelluar carcinoma(HCC). Methods Two hundred and eighty-two patients with HCC were examined by both enhanced thin slice MDCT scanning in early hepatic arterial phase,late hepatic arterial phase,portal venous phase and digital subtraction angiography(DSA). The criteria for diagnosis of APS: (1) Earlier enhancement or stronger opacification of main portal trunk and/or the first order branches compared with that of superior mesenteric vein or splenic vein;(2) Earlier enhancement or stronger opacification of the second order and smaller portal venous branches compared with that of main portal trunk. The presence and degree of APS demonstrated with MDCT and DSA were analysed by double blind method. Results In 282 HCC patients,56 were complicated with APS. MDCT demonstrated central APS in 48 patients with 41 severe and 7 moderate shunt,one revealing no APS by DSA due to the giant HCC focus. Among 7 patients with light peripheral APS,two lesions were not revealed by DSA due to faint shunt and the last lesion in the patient with mixed APS was revealed both by APS and DSA. Conclusion Multidetector CT was a simple,effective and noninvasive new technique for the diagnosis of arterioportal shunt associated with hepatocelluar carcinoma.

关 键 词：多排CT 肝细胞癌 动门脉分流 诊断标准 临床分型 

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