原发性肝细胞癌64层螺旋CT三维血管成像的特征

The characteristics of three-dimensional angiography of hepatocellular carcinoma on 64-slice spiral CT scan

目的:探讨原发性肝细胞癌64层螺旋CT三维血管成像的特征及临床应用价值。方法:对经临床及手术病理确诊的63例原发性肝细胞癌患者例行CT血管造影检查,对所得图像分别用最大密度投影、多平面重组及容积再现等三维成像技术进行分析。结果:63例动脉期发现肿瘤供血动脉属于规则性供血46例(73.0%),变异性供血12例(19.0%),寄生性供血1例(1.6%),余4例无法判断。63例中22例供血动脉明显增粗,19例明显移位。发现肿瘤血管39例,肿瘤染色48例,动-静脉瘘12例。门静脉期发现门静脉癌栓13例。结论:64层螺旋CT三维血管成像技术不仅可以准确地对肿瘤进行定位,并且能够多角度地观察肿瘤与靶血管系统的立体关系,为临床诊断和治疗提供内容丰富的信息。

Objective To explore the characteristics and clinical values of three-dimensional angiography of hepatocellular carcinoma （HCC） on 64-slice spiral CT scan. Methods CTA was performed on 63 cases of clinically and pathologically confirmed HCC by a 64-slice spiral CT. CT images were analyzed using three-dimensional reconstruction techniques including maximum intensity projection （MIP）, multiplanar reformation （MPR）, and volume rendering （VR）. Results In the arterial phase, there were 46 （73.0%） regular blood supply to the tumor, 12 （19.0%） variable blood-supply, and 1 （1.6%） parasitic blood supply, and the remaining 4 were unidentified. The artery supplying blood to the tumor was enlarged in 22 cases and shifted in 19 cases. Tumor vessels were found in 39 cases, tumor stain in 48 cases, arteriovenous fistula in 12 cases; 13 cases revealed tumor thrombi in the portal vein stage. Conclusions Three-dimensional angiographiy with 64-shce spiral CT not only accurately locates tumors, but also offers multiple angles to view the solid relationship between the tumor and. the target vessel, providing valuable information for the clinical diagnosis and treatment.