多层螺旋CT行肝脏增强后多期扫描对肝细胞癌病灶检出率的影响分析

Analysis of the effect of MDCT underwent multi-phase scan after liver enhancement on the detection rate of HCC

目的探讨多层螺旋CT(multidetector CT,MDCT)行增强后多期扫描检查肝细胞癌(hepatocellular carcinoma,HCC)病灶的效果。方法采用回顾性分析,选取2015年2月至2017年2月在莱芜市人民医院治疗的HCC患者64例,采用MDCT进行多期扫描。结果 MDCT多期扫描病灶检出率均明显高于CT平扫(P<0.05);多期扫描模式中动脉期和延迟期病灶检出率分别为97.37%和90.79%,明显高于门静脉期的77.63%(P<0.05);门静脉期肝脏、肿瘤密度值及密度差值分别为(104.01±12.29)Hu、(88.13±12.24)Hu和(17.80±2.47)Hu,明显高于其他扫描模式(P<0.05);HCC病灶典型表现为"快进快出",即动脉期多呈高密度,门静脉期和延迟期为等密度或低密度;本次研究的76个病灶中,以高-低-低密度表现为主,占68.42%。结论大部分HCC具有典型的强化特征,MDCT行肝脏增强后多期扫描能有效诊断HCC,对病灶检出和定位有重要价值。

Objective To investigate the effect of muhidetector CT （MDCT） underwent multi-phase scan after liver enhancement on hepatocellular carcinoma （HCC） lesions. Methods Retrospective analysis was used, 64 cases of HCC patients treated in Laiwu City People＇ s Hospital from Feb. 2015 to Feb. 2017 were selected, and multi-phase scan was performed by MDCT. Results The detection rate of multi-phase MDCT scan was significantly higher than that of CT plain scan （P 〈0.05）. In the multi-phase scan mode, the detection rates of arterial phase and delayed phase were 97.37% and 90.79%, which were significantly higher than that of portal vein （77.63%）, respectively （P 〈0.05）. Portal phase liver, tumor density and density difference were （104.01 ± 12.29） Hu, （88.13 ± 12.24） Hu and （17.80 v 2.47） Hu, significantly higher than those of other scanning modes （P 〈 0.05）. The typical features of HCC lesion were ＂fast forward and fast out＂ , the arterial phase was usually high density, and the portal vein and delayed phase were equal density or low density. In 76 lesions of this study, high-low-low density mainly accounted for 68.42%. Conclusion Most of HCC have typical enhancement features. MDCT multi-phase scan can effectively diagnose HCC after liver enhancement, and it is of great value for the detection and location of the lesions.