螺旋CT诊断伴肝硬化小肝癌的意义

Evaluation of dual-phase spiral CT for detecting small HCC in patients with liver cirrhosis.

目的探讨螺旋CT增强扫描诊断伴肝硬化的小肝癌的价值。方法37例伴肝硬化的小肝癌患者手术及病理发现小肝癌病灶51个(直径≤3 cm),回顾性分析螺旋CT增强扫描的结果,比较小肝癌在动脉期和门脉期的强化类型、检出率及诊断正确率。结果动脉期检出率为86.3%(44/51),门脉期为68.6%(35/51)。72.5%的小肝癌在动脉期为均一高密度灶。联合动脉期和静脉期后,其检出率分别增加至90.2%。结论动脉期扫描明显增加小肝癌的检出,两期结合能提高检出率。

Objective To evaluate the diagnosis of small hepatoeellular carcinoma （HCC） with dual - phase spiral CT. Methods 51 small HCCs were verified through operation and pathology in 37 eirrhotie patients with small hepatoeellular carcinoma. The results of dualphase spiral CT were analyzed retrospectively, including the enhancement pattern of each lesion on two phases, the sensitivity and accuracy. Results Of the 51 small HCCs, 44 （86.3%） were detected on the arterial phase and 35 （68.6%） on portal venous phase. 72.5% of small HCCs showed homogeneous high enhancement in the arterial phase. Combined the arterial with portal venous phase, the sensitivity increased significantly to 90.2%. Conclusion Arterial - phase spiral CT of the liver can significantly increase detection rate of small HCCs. Combining the two phases, the sensitivity of small hepatoeellular carcinoma would be improved considerably.