肝脏局限性肿块的发现：CT　DSA快速CTAP及MR检查的比较

Detection of Focal Hepatic Masses:Comparison of Pro Speed CT During Arterial Portography CT DSA and MR

目的：本研究的目的是比较快速ＣＴＡＰ与ＣＴ（平扫＋动态增强ＣＴ）、ＤＳＡ及ＭＲ发现肝脏局限性肿块的能力。材料与方法：在１９９４年９月～１９９５年４月的７个月中１２例患者因诊断目的进行了ＣＴ、ＤＳＡ及快速ＣＴＡＰ检查，其中４例进行了ＭＲ（ＳＥ序列）检查，然后，每一例患者的每一项检查结果由２～３名副主任以上的专业医师加以诊断。对其发现病灶数目的差异性用配对卡方检验。结果：直径小于ｌｃｍ的病灶，快速ＣＴＡＰ、ＣＴ和ＤＳＡ分别发现了１９个、６个及０个。快速ＣＴＡＰ和ＣＴ、ＤＳＡ之间的差异性极显著（Ｐ＇＝０．００００１＜Ｐ＝０．０１）。直径大于ｌｃｍ而小于４ｃｍ的病灶，快速ＣＴＡＰ、ＣＴ和ＤＳＡ分别发现２３个、１７个和１２个，快速ＣＴＡＰ和ＣＴ、ＤＳＡ之间的差异分别具有显著性（Ｐ＜０．０５）和极显著性（Ｐ＜０．０１）。病灶直径大于４ｃｍ，快速ＣＴＡＰ、ＣＴ和ＤＳＡ均发现５个病灶，其差异无显著性。在４例进行了ＭＲ检查的患者中，直径小于２ｃｍ的病灶，快速ＣＴＡＰ和ＭＲ分别发现了１２个和７个病灶，其差异性显著（Ｐ＇＝０．０３７３＜０．０５）；当病灶直径大于或等于２ｃｍ，快速ＣＴＡＰ和ＭＲ均发现９个病灶，其差异无显著性。结论?

The purpose of this paper was to compare pro speed CTAP with CT (plain CT and dynamic,sequential,contrast-enhanced CT),DSA and MR for detection of focal hepatic masses.Materials and Methods:From September,1994 to April,1995,12 patients were examined with CT,DSA and pro speed CTAP.Four of them were studied with MR(SE sequences).Each of the examination was evaluatec by a panel of radiologists.The numbers of detected lesions were analyzed using the Mc Nemar's test.Results:Of the lesions smaller than lcm in diameter.Pro speed CTAP depicted 19 lesions,and CT 6 lesions,DSA zero.The difference between pro speed CTAP and CT,DSA was statistically significant(P'=0.00001<0.01);Of the lesions which were 1 to 4cm in diameter,pro speed CTAP depicted 23 lesions,CT 17 lesions and DSA 12 lesions,the difference between pro speed CTAP and CT,DSA was also statistically significant(P<0.05,P<0.01 respectively);Of the lesions larger than 4cm in diameter,they all depicted 5 lesions.The difference between them was not significant.In four patients who were performed with MR:Of the lesions smaller than 2cm in diameter,pro speed CTAP depicted 12 lesions,and MR 7 lesions,The difference between them was statistically significant(P'=0. 0373<0.05);Of the lesions equal or larger than 2cm in diameter,pro speed CTAP and MR both depicted 9 lesions.The difference was not significant.Conclusion:Pro speed CTAP is more sensitive than CT,DSA,and MR for detection of small lesions.