三期螺旋CT扫描对肝癌诊断的研究

Three-phase spiral CT in evaluation of hepatic carcinoma

目的：评价三期螺旋ＣＴ检查肝癌的价值。材料与方法：对８６例１１６个肝癌进行了三期螺旋ＣＴ扫描。统计各期病灶的检出数，观察病灶增强方式。由两位ＣＴ室医师以双盲法观察诊断。结果：肝癌在肝动脉期、门静脉期和延迟期的检出率分别为８７％（１０１／１１６）、７３％（８５／１１６）和７１％（８２／１１６）。１７个病灶仅显示在动脉期，４个病灶仅显示在门静脉期，８个病灶仅显示在延迟期。７８％肝癌在动脉期呈高密度，７３％在门静脉期呈低密度，７１％在延迟期呈低密度。结论：动脉期显示的病灶数最多，然而，有些病灶仅显示在门静脉期和延迟期，因此，为了能最大限度显示病灶，三期螺旋ＣＴ扫描的采用是必要的。

Objective: To evaluate the effectiveness of three - phase spiral computed tomography for the evaluation of hepatic carci- noma. Materials and Methods: Images obtained at three - phase CT in 86 patients with 116 hepatic carcinoma were reviewed. The number of the detected lesions were calculated on each phase and the pattern of enhancement observed. The CT appearances were inde- pendently reviewed in a double blind method by two radiologists. Results: The detectability of hepatic carcinoma in the arterial - phase (AP), portal - phase(PP), and delayed - phase(DP) were 87% (101 /116), 73% (85/116), and 71% (82/116). respectively. Seventeen lesions were detected only in AP, four in PP, and eight in DP. 78% of hepatic carcinoma were hyperdense in the AP, 73% were hypo- dense in PP, and 71% were hypodense in DP. Conclusion: Lesions detected and conspicuity were best with the AP. However, some le- sions were detected only with DP and PP, so that maximum lesion visualization is achieved by using all three - phases.