64层螺旋CT后处理技术对肝癌的诊断价值

Diagnostic Value of Post-processing Techniques of 64-slices Helical CT in Hepatocellular Carcinoma

目的探讨64层螺旋CT后处理技术对肝癌的诊断价值。方法对临床疑为原发性肝癌的30例患者进行64层螺旋CT扫描,并应用多平面重建(multiplanar reconstruction,MPR)、最大密度投影(maximum intensity projection,MIP)、计算机容积重组(computed volume reconstruction,CVR)和容积再现(volume rendering,VR)等技术进行重组,观察肝癌肿块本身及淋巴结、血管的显示情况,并与临床检查和手术病检或穿刺活检结果进行对比。结果 MPR能清楚显示病灶的形态、边缘、大小、密度以及周围组织如门静脉、肝静脉、下腔静脉及胆道系统的侵犯情况等,也能清楚显示相邻器官如膈、胃、胆囊及胰腺等情况;MIP能较好地显示肝脏血管系统及肿瘤供血动脉;CVR能较好显示淋巴结情况;VR能够直观地了解病灶的位置、形态及周围组织关系。结论 64层螺旋CT后处理技术能够较好地显示肝癌病灶、血管、淋巴结及周围组织侵犯情况,具有更全面、直观、准确的特点,是一种重要的辅助检查方法。

Objective To discuss the diagnostic value of post-processing techniques of 64-slices helical CT in displa- ying hepatocellular carcinoma hepatocelluar carcinoma. Methods Thirty patients with hepatocelluar carcinoma suspected by clinical examination were scanned by 64-slices helical CT.Multiplanar reconstruction （MPR）, maximum intensity pro- jection （MIP） , computed volume reconstruction （CVR） and volume rendering （VR） images were obtained.The masses, the lymph nodes and the feeding vessels were observed.The results were compared with clinical examination and surgical or vivi-puneture results.Results The MPR imaging not only displayed distinctly the shapes, margins, sizes, density of the tumors and the adjoining parenchyma such as the portal venous system, hepatic venous system,inferior vena cava and the bile duet system infringed and so on, but also displayed the adjacent apparatus as the diaphragm, stomach,gallbladder and pancreas. The blood vessels of the normal liver and the masses were displayed clearly in the MIP imaging, thus the lymph nodes were displayed well in the CVR imaging. The VR imaging showed accurately both the position and shape of the lesions, and the relations with the peripheral tissues.Conclusion The post-professing techniques of 64-slices helical CT can show the lesions, feeding vessels, lymph nodes of hepatocelluar carcinoma and the invasion of peripheral tissues clearly, which is an important auxiliary examination method in diagnosis of the hepatocelluar carcinoma.