乙肝肝硬化相关性小肝癌的影像学诊断分析

Imaging Diagnosis of Small Hepatocellular Carcinoma Related to Hepatitis B Cirrhosis

目的探讨CT对乙肝肝硬化相关性小肝癌(SHCC)的诊断价值。方法回顾性分析我院收治的73例乙肝肝硬化相关性SHCC临床资料,术前均行肝脏CT平扫和增强扫描,以病理结果为金标准,分析CT对乙肝肝硬化相关性SHCC的诊断价值。结果 73例患者中,CT平扫检出SHCC癌灶59个(64.13%),CT增强扫描检出SHCC癌灶85个(92.39%),CT增强扫描检出率显著高于平扫(P<0.05);其中60例为单发,13例为多发;癌灶形态为类圆形,直径0.6-3.0(2.09±0.65)cm;分布位置:肝右叶54例,肝左叶19例;CT平扫高密度3个,低密度56个,等密度34个;肝动脉期检出癌灶84个(91.30%),高密度(明显均匀强化)63个,边缘强化或中心点状强化17个,低密度4个,等密度8个;门脉期检出癌灶66个(71.74%),高密度8个,低密度58个,等密度26个;延迟期检出癌灶73个(79.35%),均呈低密度,另19个呈等密度。各期扫描检出率存在显著差异(P<0.05)。结论 CT三期增强扫描可显示乙肝肝硬化相关性SHCC的强化特征,有助于提高SHCC的检出率。

Objective To explore the diagnostic values of CT for small hepatocellular carcinoma（SHCC） related to hepatitis B cirrhosis. Methods The clinical data of 73 cases of patients with hepatitis B cirrhosis-associated SHCC in our hospital were analyzed retrospectively. And they were given the CT plain scan and enhanced scan for liver preoperatively. The pathological results were taken as the gold standard to analyze the diagnostic values of CT for hepatitis B cirrhosis-associated SHCC. Results Among the 73 patients, 59（64.13%） cases of SHCC cancer were detected by CT plain scan and 85（92.39%） cases were detected by CT enhanced scan, and the detection rate of CT enhanced scan was significantly higher than that of plain scan（P〈0.05）. Among them, 60 cases were single lesions and 13 cases were multiple lesions. The morphology of the lesion was round with the diameter of 0.6-3.0（2.09±0.65） cm. 54 cases were distributed in right lobe of liver and 19 cases in left lobe of liver. There were 3 high density, 56 low density and 34 equal density by CT plain scan. In the hepatic artery phase, 84（91.30%） cancer foci were detected, 63 in high density（markedly uniform enhancement）, 17 in edge enhancement or central point enhancement, 4 in low density and 8 in equal density. In the portal venous phase, 66（71.74%） cancer foci were detected, 8 in high density, 58 in low density and 26 in equal density. In the delayed phase, 73（79.35%） cancer foci were detected with low density, and other 19 in equal density. There were significant differences in the detection rate in the each phase（P〈0.05）. Conclusion Three-phase CT enhanced scan can show the enhanced features of hepatitis B cirrhosis-associated SHCC and help to improve the detection rate of SHCC.