螺旋CT三期增强扫描在肝脏肿瘤鉴别诊断中的价值

The value of three enhanced spiral CT scan on differential diagnosis of liver tumors

目的:评价螺旋CT三期扫描在肝脏肿瘤鉴别诊断中的价值,重点探讨动脉期、门静脉期及延迟期扫描的意义,以进一步提高CT诊断的正确性。方法:100例肝脏肿瘤[38例肝血管瘤,28例原发性肝癌,23例肝转移瘤,4例肝脏局灶性结节性增生(FNH),5例肝脓肿,2例肝母细胞瘤]行螺旋CT三期增强扫描。一次屏气完成全肝扫描,观察肿瘤三期强化的方式和特征。结果:38例肝血管瘤准确定性36例,2例诊断不典型血管瘤可能;28例肝癌误诊4例;23例肝转移瘤中多发性转移瘤无1例误诊,1例单发转移瘤误诊;4例FNH中有1例误诊为纤维板障型肝癌;肝脓肿及肝母细胞瘤均诊断明确。结论:螺旋CT三期扫描在肝脏肿瘤鉴别诊断中具有重要价值,是肝脏肿瘤鉴别诊断的最佳方法,应作为肝脏肿瘤的常规扫描方法。

Objective： To evaluate the value of three enhanced spiral CT scan on the differential diagnosis of liver tumors, explore the significance of focusing on the arterial phase, portal venous phase and delayed phase scanning and further improve the accuracy of CT diagnosis. Methods： Three enhanced spiral CT scan of one hundred cases of liver cancer （38 cases of hepatic hemangioma, 28 cases of primary liver cancer, 23 cases of liver metastases, four cases of FNH, 5 cases of liver abscess, two cases of hepatoblastoma） were performed. Completion of a breath - hold scan of the whole liver, the tumor three enhanced methods and characteristics were observed. Results： Three enhanced for spiral CT scan differential diagnosis of liver tumors was the best way ; 38 cases of hemangioma and accurate characterization of 36 cases, 2 patients were diagnosed with atypical hemangioma may be ; 28 cases of liver cancer misdiagnosis in 4 cases ; no misdiagnosis of multiple metastases, and 1 single transfer of misdiagno- sis ; four cases misdiagnosed as FNH fiberboard barrier hepatocellular carcinoma in 1 case ; liver abscess and liver were diagnosed neuroblastoma. Conclusion ： Three enhanced spiral CT of three liver tumors in the differential diagnosis have great value, should be used as conventional scanning methods of liver tumors.