256排CT三期扫描及三维血管成像重建在原发性肝癌诊断中的价值

Diagnostic value of tri-phase scanning with 256-row CT and 3D imaging reconstruction in primary hepatic carcinoma

目的探讨256排CT三期扫描及三维血管成像重建技术在原发性肝癌诊断中的应用价值。方法从2011年9月至2013年9月收治的原发性肝癌患者中随机选择105例,给予256排CT三期扫描及三维血管成像重建,并与同期行肝动脉DSA的58例患者进行对比分析。结果肝动脉期MSCTA可以良好的显示出腹腔干及其主要分支、肝动脉解剖变异,VR对血管的立体显示效果优于MIP,但在肝内动脉显示方面存在差异。MIP和VR法检查在供血动脉显示方面存在差异,但差异无统计学意义(P>0.05);在肿瘤血管显示方面,差异有统计学意义(P<0.05)。在显示肝动脉3级以下分支以及肿瘤供血动脉和肿瘤血管方面,MIP与DSA间差异无统计学意义(均P>0.05)。在显示4级以上分支方面,DSA优于MIP,且经比较差异有统计学意义(P<0.05)。在门静脉4级以上分支显示方面,MIP和VR经比较差异均无统计学意义(均P>0.05)。结论 256排CT三期扫描及三维血管成像重建在原发性肝癌诊断中具有较高的应用价值。

Objective To explore the application value of tri-phase scan with 256-row CT and 3D imaging reconstruction in diagnosis of primary hepatocellular carcinoma （HCC）. Methods One hundred and five patients with HCC admitted in our hospital from September 201 1 to September 2013 were enrolled,and given tri-phase scanning with 256-row CT and 3D imaging reconstruction, which compared with 58 cases of patients who underwent hepatic artery DSA concurrently. Results The celiac trunk and its main branches,as well as anatomical variation of hepatic artery,could be clearly showed by the hepatic arterial phase in multislice spiral computed tomography （MSCTA）. Vascular stereo display effect of volume rending （VR）was better than that of multiplane reconstlllction （MIP）,but differences existed in display of intrahepatic arteries. There was difference between effects by MIP and VR examination on showing supplying arteries, which showed no statistical significance （P〉0.05）;nevertheless,statistically significant difference in displaying tumor blood vessels by MIP or VR was found （P〈0.05 ）. In displaying 3th grade and even smaller hepatic artery branches,and supplying arteries of the tumor and tumor blood vessels,the differences between MIP and DSA were statistically significant （P〈0.05）;in display of smaller than 4th grade branches of hepatic artery,DSA was significantly better than MIP （P〈0.05）. In the display of smaller than 4th order branches of portal vein,the difference between MIP and VR was not significant （P〉0.05 ）. Conclusion Tri-phase scanning,256-row CT and 3D MSCTA reconstruction are of great value in diagnosis of HCC.