经动脉门脉造影CT(CTAP)在小肝癌诊断中的临床应用和研究

Clinical Application and Study of Computed Tomography Arterial Portography in the Diagnosis of Liver Cancer

近年来,经动脉门脉造影CT(computed tomography arterial portography,CTAP)仅少数国外作者进行了原发或继发性肝癌诊断研究。我们共进行了25例CTAP 检查,其目的为了解CTAP 法在发现肝脏实质占位病灶(直径≤3.0cm)的敏感性如何,并且同其他影像诊断技术进行比较。结果显示:15例小肝癌病人经手术病理证实共发现21个病灶(肿瘤直径≤3.0cm),CTAP 对肿瘤直径≤3.0cm 和≤1.0cm 的敏感性分别为90.5%(19/21)和75%(6/8),明显高于其他影像诊断技术。我们对肝癌在CTAP图上的表现和是否存在门静脉参与供血等问题进行了探讨,总之,CTAP 在发现肝内小占位病灶(尤其直径≤1.0cm)的敏感性是目前所有影像诊断技术中最高的一种检查方法。怀疑肝内有占位病灶者,可合理选择性使用。

Clinical application of computed tomography arterial portography(CTAP)in the diagnosis for metastatic and primary liver cancer was reported by only few authors in the recent years. This technique was performed in 25 patients in our hospital in order to evaluate the sensitivity and compare it systematically with other imaging modalities.The results showed that in 15 cases of small hepatocellular carcinoma with the number of 21 lesions confirmed by surgicopathology,the sensitivity of CTAP reached up to 90.5%(19/21)for lesion≤3.0cm and 75%(6/8)for lesion≤1.0cm,much higher than that of other imaging modalities.CT appearances and mode of portal vein supply of hepatocellular carcinoma on CTAP were discussed.We got final conclusion that CTAP was the most sensitive technique in detection of small lesions(diameter≤1.0cm,esp.)and should be considered in very suspicious and selective cases.