多层螺旋CT四期动态扫描对肝硬化小结节定性诊断的初步评价

Preliminary evaluation on qualitative diaguosis of 4-phase dynamic scanning with multi-slice spiral CT in the detection of small hepatocirrhotic nodules

目的评价多层螺旋CT(MSCT)四期动态扫描对肝硬化小结节的检出率,并对检出敏感性和定性准确性进行研究。方法经B超检查有直径小于3cm的肝硬化小结节者60例,行多层螺旋CT四期动态扫描,统计各期病灶的检出数,观察病灶强化方式,计算检出敏感性。采用美国GE公司的Lightspeed 4层螺旋扫描机行增强后四期扫描,第一期的延迟时间为25s,第二期为50s左右,第三期为90s,第四期180s。结果60例共发现72个,其中56个小肝癌,再生结节6个,退变结节10个。平扫发现36个病灶(63%,36/56);第一期、第二期、第三期及第四期病灶检出敏感性分别为66%、58%、50%、92%。结论肝硬变小结节增强扫描表现形式复杂,螺旋CT四期扫描可以充分显示肝硬化小结节各期的增强表现,充分反映小结节血供的特点,提高了病灶的检出率和定性诊断的准确率、

Objective To evaluate the detection rate of 4-phase dynamic scanning with multi-slice spiral CT （MSCT） in examination of small hepatoeirrhotic nodules and compare the sensitivity and accuracy of detection. Methods 60 cases of hepatoeirrhosis with small intro-hepatic nodules （diameter 〈 3cm） confirmed by B-ultrasound were selected and underwent 4-phase dynamic scanning with MSCT. The number of the detected lesions and their sensitivity were calculated and analyzed in each phase, the pattern of enhancement was observed. The first phase scan,the second phase scan,and the third phase scan were started at 25s,50s,90s,and 180s respectively after the injection of contrast medium. Results 72 lesions were detected in all of 60 cases, among them the sHCC was 56,regenerative and dysplastic nodules were 6 and 10 respectively,36 lesions were found by using plain scan.The study showed that the sensitivity in detecting lesions in first,second, third and fourth phases were 66% ,58% ,50% ,92% respectively. Conclusion It is obvious that 4-phase dynamic CT scanning can fully reflect the blood supply of sHCC、RN、DN and enhance the detection rate of lesions and accuracy of qualitative diagnosis.