螺旋CT对小肝癌的诊断意义

Diagnostic significance of spiral CT in hepatocellular carcinoma

目的 探讨螺旋ＣＴ扫描在肝动脉造影ＣＴ（ＣＴ ｈｅｐａｔｉｃ ａｒｔｅｒｉｏｇｒａｐｈｙ，ＣＴＨＡ）和经动脉门脉造影ＣＴ（ＣＴａｒｔｅｒｉａｌ Ｐｏｒｔｏｇｒａｐｈｙ，ＣＴＡＰ）中的应用价值。方法分析２８例小肝癌灶（直径＜３．ｏｃｍ）ＣＴＡＰ和ＣｆｆｉＡ的图像，并与双期增强扫描进 行对照。结果 ＣＴＡＰ病灶检出率为ｇｉ．５％，ＣＴＨＡ病灶检出率为９０％。可检出０．２－０．ｓｃｍ的小病灶。ＣＴＨＡ和ＣＴＡＰ均可出现 非病理性表现，ＣＴＡＰ灌注异常出现率为１２．５％，ＣＴＨＡ非病理性强化灶出现率为１８．５％。结论螺旋ＣＴ动脉造影能显著减少 造影剂用量，提高图像质量，ＣＴ动脉造影能提高微小肝癌的检出率。ＣＴＡＰ和ＣＴｈＡ结合分析，可减少假阳性率。

Objective To evaluate the usefulness of spiral CT arterial Portogrataphy (CTAP) and CT hepatic arteriogr aphy (CTHA). Methods CTAP and CTHA manifestations in 28 patients with smll hepatocellular carcinoma (≤3cm in diameter) were analyzed and compared with those in biphase enhanced CT. Results The detection rate of CTAP and CTHA was 91.5% and 90%, respechvely. They could reveal the tumors of 0.2-0.5cm in diameter.Both CTAP and CTHA gave falisePositive fidings, such as perfusion defects in 12.5% of CTAP and nonpathologic enhancement in 18.5% of CTHA. Conclusion By the use of spiral CT technique, the quantity of contrast material administrated in CTAP and CTHA could be considerably redeced, and the quality Of CT images signficantly improved. The detection rate of CTAP and CTHA was higher than that of biphase enhanced CT. Simultaneous use of both procedues may help the decrease of the false Positive rate, and the increase of the sensitivity of diagnosis for small hepatocelluar carcimoma.