肝动脉造影螺旋CT扫描在小肝癌诊断中的应用研究

The application of spiral CT angiography in diagnosis of small hepatic carcinoma

目的:探讨肝动脉造影螺旋CT扫描技术(CTA)对小肝癌的检出能力及定性诊断价值。方法:对92例经B超、CT、血管造影检查发现肝内占位性病灶而不能定性诊断的患者实施CTA检查,应用导管技术将5F导管插至肝动脉后,以2ml/s的速率注射造影剂5 s后进行螺旋CT扫描。结果:CTA检出小肝癌48例,共74个病灶。动脉期病灶呈高密度强化,可分为均匀强化及不均匀强化两种类型,动态扫描观察病灶呈快进快出强化表现,供血动脉的显示及门脉期环状强化则是定性诊断的重要依据,CTA能够较好地反映出病灶的强化特点及供血特征。结论:通过与B超、血管造影、普通CT等常规影像技术相比较,CTA对肝内直径≤3 cm的小肝癌的检出能力及定性诊断价值明显提高,对小肝癌患者的早期手术治疗具有重要意义。

Objective: To evaluate the detection ability and accuracy of diagnosis value of CTA in small hepatic carcinoma (SHC). Methods: Ninety-two patients who had been performed by B ultrasound, plain CT, DSA and were considered with unclear lesions in the liver were examined by CTA. Using catheter technique, 5F catheter was put into hepatic artery. Five minutes after injection (at the speed of 2ml/s), scanning started. Results: Forty-eight cases of SHC were detected, including 74 lesions. The lesions were hyperdensity in arterial phase, maybe homogeneous or inhomogeneous enhancement. Dynamic scanning showed the fast - in and fast - out enhancement pattern. The manifestation of the feeding artery and ring-like enhancement in portal vein phase were of high value to diagnosis. CTA can demonstrate the characteristics of enhancement and feeding artery. Conclusion: Compared with B ultrasound, DSA and CT, CTA has high detection rate and diagnostic accuracy of SHC. As a result, CTA has important value to direct the operation therapy of SHC patients earlier.