早期肝癌螺旋CT多期增强扫描的影像学特征分析

The multi-phase helical computed tomography features of patients with early hepatocellular carcinomas

目的分析早期肝癌的各期增强图像的特点,以期提高临床早期肝癌的检出率。方法以本院手术病理或临床随访证实的直径3cm以下的115例肝占位患者为研究对象,回顾性分析早期肝癌患者64排螺旋CT多期增强扫描各期图像的特点,其中肝细胞癌42例,肝转移癌37例,肝血管瘤36例。结果三组病例在性别构成、年龄分布方面均无显著差异(P均>0.05)。肝细胞癌在动脉期多表现为高密度强化,比例显著高于肝转移癌(P<0.001);而在门静脉期和平衡期多表现为低密度无强化,比例亦显著高于肝转移癌和肝血管瘤(P<0.001)。结论 64排螺旋CT多期增强扫描是诊断早期肝癌行之有效的方法。

Objective This study aimed to analyze the helical computed tomography （CT） features of patients with early hepatocellular carcinoma （HCC）, so as to promote the diagnostic rate of early HCC. Methods Total of 115 cases of liver lesions less than 3 cm in diameter proved by pathological examination or clinical follow-up were screened, including 42 patients with hepatocellular carcinoma, 37 patients with metastatic liver cancer and 36 patients with hepatic hemangioma;and the characteristics of the enhanced multi-slice spiral CT scanning images were retrospectively analyzed. Results In this cohort, the difference in either gender or age among patients with hepatocellular carcinoma, metastatic liver cancer or hepatic hemangioma was not signiifcantly （both P＆lt;0.05）. In the arterial phase, majority of patients with hepatocellular carcinoma reveals high-density enhancement, and the proportion was signiifcantly higher than that of patients with metastatic liver cancer （P＆lt;0.001）;while in the venous and equilibrium phases, patients with hepatocellular carcinoma reveals low-density and no enhancement, and the proportion was also signiifcantly higher than that of patients with metastatic liver cancer or hepatic hemangioma （P ＆lt; 0.001）. Conclusions Multi-phase enhanced scanning using the 64-slice spiral CT is an effective method for diagnosing early hepatocellular carcinoma.