16层螺旋CT双动脉期与门脉期诊断原发性肝癌的临床应用

Clinical application of double arterial phase and portal venous phase 16-slices helical CT in diagnosis of hepatocellular carcinoma

目的分析原发性肝癌多层面CT（multi-slicesCT,MSCT）双动脉期与门静脉期增强扫描各期强化特征,评价三期增强扫描对癌灶的检出率。方法101例原发性肝癌治疗前行MSCT的平扫,以3ml/s肘静脉注射100ml对比剂后,行动脉早期20-22s,动脉晚期34-37s,门静脉期60s扫描。测病灶平扫及各增强期CT值,观察病灶的强化情况及检出情况,以增强各期检出的肿瘤为癌灶总数。结果三期增强扫描一共显示445个病灶,〈3cm癌灶199个,动脉早期检出108（54.27%）,动脉晚期检出162（81.40%）,门静脉期检出131（65.83%）;〉3cm的癌灶246个,动脉早期检出228（92.68%）,动脉晚期检出236（95.93%）,门静脉期检出224（91.06%）。49个仅在三期增强扫描的一期显示,动脉早期5个,动脉晚期21个,门静脉期23个。结论动脉晚期的检出率明显高于门静脉期与动脉早期。双动脉期与门静脉期增强扫描可提高肝癌检出率。

Objective To analysis CT findings of hepatocellular carcinoma in double arterial phase and portal venous phase of Multi-slices CT（MSCT） and to evaluate their effect on detection of cancer lesions. Methods One hundred and one patients with hepatocellular carcinoma were examined by abdominal plain CT and MSCT scanning at 20-22 s （early arterial phase, EAP）, 35-37 s （late arterial phase, LAP） and 60 s （portal venous phase, PVP）. The CT density of hepatocellular carcinoma were measured, and lesion detection and CT appearance were analyzed. Results In three enhanced phase, 445 cancers were detected. One hundred and eight lesions （less than 3 cm） were found and the detection rate was 54.27%, 81.40%, and 65.83% respectively in EAP, LAP and PVP, while 246 lesions equal to or more than 3 cm were found and their detection rates were 92.68%, 95.93% and 91.06%. Forty-nine lesions were seen only in one of contrast-enhanced imaging phase, including 5 lesions at EAP, 21 at LAP and 23 at PVP. Conclusion The detection rate of LAP is higher significantly than that of LAP and PVP. Tri-phase MSCT can improve detection and visualization of hepatocellular carcinoma.