CT平扫结合增强扫描在肝右叶Ca伴门静脉右支癌栓诊断中的价值

The Value of CT Combined with Enhanced Scan in the Diagnosis of Portal Vein Tumor Thrombus in the Right Liver with Ca

目的探讨CT平扫结合增强扫描在肝Ca伴门静脉癌栓诊断中的应用价值。方法回顾性分析我院2014年3月-2016年5月期间接收诊治的31例肝Ca伴门静脉癌栓患者的临床资料和CT平扫与增强扫描影像学资料。结果 31例肝右叶Ca伴门静脉右支癌栓患者中I型患者8例,II型患者7例,III性患者11例,IV型患者5例;癌栓在CT平扫中29例为等密度,2例呈稍低密度,门脉主干直径约1.5cm-3.4cm,平均(2.3±0.51)cm;增强扫描动脉期21例癌栓有轻度增强,5例出现管壁增强;CT增强静脉期,23例为低密度充盈缺损影。结论 CT平扫结合增强扫描诊断肝右叶Ca伴门静脉右支癌栓的特异性为100%,不仅能精准的确定癌栓时期,完整确定癌栓的大小、部位等,还能够做到无创、便捷等特点,值得临床进一步推广和应用。

Objective To investigate the value of CT combined with enhanced scan in the diagnosis of portal vein tumor thrombus in the right liver with Ca. Methods Retrospectively analyze CT angiography data and clinical data of 31 patients from March 2014 to May 2016. Results Among 31 patients, there are 8 cases of the type Ⅰ, 7 cases of type Ⅱ, 11cases of type Ⅲ, and 5cases of type Ⅳ. There are 29 cases of equal density thrombus, 2 cases of slightly low density thrombus, the diameter of portal vein is about 1.5cm - 3.4cm and an average of （2.3±0.51）cm. There are 21 cases of slightly enhancement thrombus and 5 cases of reinforced walls in the enhanced scan artery phase. There are 23 cases of low-density filling defects in the CT enhanced venous phase. Conclusion The specificity of the diagnosis of portal vein tumor thrombus in the right liver with Ca is 100%. It not only determines the precise period of thrombus, the size, location and other parameters of tumor thrombus, but also is able to be non-invasive and convenient, which is worthy of further promotion and application.