多层螺旋CT团注造影剂跟踪技术在肝脏增强中的研究及应用

The Study and Application of the Multislice spiral CT Contrast Media Bolus Injection Track Technique in the Contrast Enhancement of Liver

目的 研究确定有或无肝硬化患者的动脉期最佳扫描起始的阈值（CT值），以获得最佳的动脉期图像，避免肝硬化的病理因素的影响，提高肝脏肿瘤特别是原发性小肝癌的检出率及鉴别力。方法根据病史、实验室检查及CT平扫表现等将病例分为正常组和肝硬化组各100例。上述两大组再根据在腹腔动脉开口处的腹主动脉腔内预设的不同CT值即130、140、150、160、170、180、190、200、210、220Hu各自分成10小组，每小组均为10例。同时记录动脉期开始的扫描时间。结果正常组的最佳预设阈值在150—180Hu之间，肝硬化组的最佳预设阈值在180—220Hu之间，两组的最佳预设阈值有差异。结论用CT团注造影剂跟踪技术（Sure—Start软件技术）可较准确获得最佳的肝脏动脉期图像，克服肝硬化病理因素的影响，提高肝脏肿瘤特别是原发性小肝癌的检出率及鉴别力。

Objective To ascertain the optimal threshold value of arterial phase scan time of patients with and without hepatocirrhosis, to obtain the best arterial phase image, and to improve the detective effectiveness and differentiation ability of hepatic tumor, especially primary small liver cancer. Methods According to the medical record, laboratory examination and features of CT plain scan, the patients were divided into two groups including normal group and hepatocirrhosis group with 100 cases each. Then each group was subdivided into ten small groups with 10 cases each, according to the different CT threshold values （ 130, 140, 150 , 220Hu） presupposed in the coeliaca arteria of the layer of celiac artery. Then record the starting scan time of the arterial phase. Results The optimal threshold value of normal group was at 150-180Hu, while that of the hepatocirrhosis group was at 180-220Hu. The optimal threshold value of the two groups was distinctly different. Conclusion The track technique of contrast media bolus injection could overcome the pathological influence of hepatocirrhosis, obtain the best arteria phase image, and improve the detective effectiveness and differentiation ability of hepatic tumor, especially primary small liver cancer.