320排CT对肝癌的诊断价值研究

The diagnostic value of 320-slice CT angiography for liver cancer

目的评价320排CT和CT血管造影(CTA)三维辅助成像技术在肝癌诊断中的应用价值。方法回顾性分析41例合并门静脉癌栓(PVTT)的肝癌患者在介入治疗前分别行肝脏320排CT和16排CT的CTA影像资料,比较两种CT在显示肝内瘤灶、PVTT、动静脉瘘(AVF)和肝动脉起源走行等方面的差异。结果以数字减影血管造影(DSA)为参照,41例PVTT患者中应用320排CT诊断瘤灶39例,明显优于16排CT诊断的32例;320排CT和16排CT诊断瘤灶的灵敏度分别为97.6%和92.7%,诊断AVF的准确度分别为97.1%和85.4%;两者对肝动脉起源走行和解剖变异的显示基本一致。结论 320排CT和CTA除了具备16排CT的优点外,还能以更高的图像质量完成对肿瘤及肝脏血管的四维成像,诊断原发性肝癌更快速、准确,对介入治疗更具指导意义。

Objective To evaluate the diagnostic value of 320-slice CT and 320-slice CT angiogra- phy（CTA） for hepatocellular carcinoma. Methods A retrospective analysis of 41 liver cancer patients with portal vein tumor thrombus（PVTI＇） with 320-slice and 16-slice CT scan in the 3D reconstruction of vessels before interventional treatment was conducted. The differences of the two CT scans in detecting the hepatic tumor foci, PVTI＇, arteriovenous fistula （AVF） and hepatic artery origin were compared. Results 39 patients were diagnosed PVTF using 320-slice CT, while 32 patients were confirmed with 16-slice CT. With DSA as the standard, 320-slice CT showed a higher sensitivity in tumor foci and AVF than 16-slice CT with the diagnosis sensitivity of tumor foci and AVF （97.6% vs 92. 7% and 92. 7% vs 58. 8% ）. The diagnosis accuracy of AVF with 320-slice CT （97. 1% ） was obviously superior to the 16-slice CT （85.4%）. The display of hepatic artery origin travel and anatomical variation using the two CT scans were consistent with DSA. Conclusion 320-slice CT and CTA not only possessed the advantages of 16-slice CT, but also had higher image quality of tumor and liver vascular four dimensional imaging, and faster, more accurate diagnosis of PLC, which can effectively guide the interventional therapy.