微小肝癌影像学诊断探讨

The Discussion of Imaging Diagnosis on Weeny Hepatic Carcinoma.

目的探讨MSCT、DSA及碘油CT对微小肝癌的诊断价值。方法收集本院2003年6月-2007年6月经手术、病程及随访证实26例微小肝癌的MSCT、DSA及碘油CT资料，对其检查方法和影像学表现进行回顾性分析。结果26例微小肝癌MSCT检查发现病灶23例，其中动脉期病灶早期强化17例，平衡期病灶呈低密度影15例。DSA检查12例，检出病灶10例，其中2例为MSCT检查阴性、2例除证实主灶外，发现更微小子灶。12例DSA检查同时注入碘油，复查CT，碘油沉积8例，其中1例为MSCT，DSA检查均为阴性者。结论MSCT肝脏扫描多期进行，能提高微小肝癌检出率，“快进快出”仍是微小肝癌的特征。DSA对肝脏微小占位显示的敏感性、特异性高，具有不可替代的作用。碘油CT同时兼有诊断与治疗作用，临床意义更大。

Objective To discuss diagnosis value for the weeny hepatic carcinoma by using MSCT, DSA and lodine CT. Methods Collect the materials of 26 patients who are diagnosed the weeny hepatic carcinoma according to the examination of MSCT, DSA and lodine CT from in June, 2003 to in June, 2007, whose diagnosis is the same as the results of operation, the procession of cure and visiting, to analyze the methods of examining and imaging manifestation in retrospective method. Results The study shows that 23 lesions are found in 26 patients by MSCT, 17 lesions are in early arterial increased phrase, 15 lesions appearing low density images are found in balanced phrase. 12 patients are examined by DSA, ten of whom are found lesions, two of them manifest negative patients by MSCT, and another two patients are found smaller lesions besides big lesions. These 12 patients are injected iodine when examined by DSA and iodine is precipitated in eight patients of them examined by CT. One of them is negative patient with the examination of MSCT and DSA. Conclusions Using MSCT is very useful to increase the detectable rate of weeny hepatic carcinoma. ＂Fast enter and fast flow＂ is always the character of weeny hepatic carcinoma. Because of its high sensitivity and distinction, DSA can＇ t be replaced by others on the examination of the small lesions, lodine CT has an important part in diagnosis and treatment and its clinical value is also greater.