多层螺旋CT平扫及三期动态增强扫描对肝细胞癌的诊断价值研究

The Diagnostic Value of Multi-slice Spiral CT and Three-phase Dynamic Enhanced Scan in Hepatocellular Carcinoma

目的探讨分析多层螺旋CT(MSCT)平扫及三期动态增强扫描对肝细胞癌诊断中的应用价值。方法回顾性分析2015年3月到2017年3月期间收集的52例经手术病理证实患有肝细胞癌患者的CT检查资料,分析CT平扫及三期增强扫描对肝细胞癌的诊断应用价值。结果 (1)运用64排128层螺旋CT多期增强扫描共诊断出14例患者伴有肝硬化,共检出肝癌病灶82个,病灶在CT平扫上显示为稍低密度,在三期动态增强扫描中病灶为"快进快出"式典型强化,具体表现为动脉期强化,其中3个病灶动脉期未明显强化;门脉期强化程度逐渐下降,延迟期呈低密度。与手术病理诊断结果相比,64排128层螺旋CT多期增强扫描三期综合检出率高达100%。(2)多层螺旋CT三期动态增强扫描对肝细胞癌的病灶检出率分别为:动脉期检出率达为96.34%,门脉期的检出率为82.92%,延迟期的检出率为87.80%。结论在临床肝细胞癌诊断中,运用64排128层螺旋CT多期增强扫描,可以清晰反映肝细胞癌的血供变化特点,为临床早期诊断肝细胞癌提供可靠的影像学依据,在肝细胞癌诊断以及病情监测方面有重要的临床意义。

Objective To investigate the value of multi-slice spiral CT（MSCT） plain scanning and three-phase dynamic contrast-enhanced scanning in the diagnosis of hepatocellular carcinoma. Methods CT findings of 52 patients with hepatocellular carcinoma confirmed by surgery and pathology collected from March 2015 to March 2017 were analyzed retrospectively. The CT and CT scanning were analyzed retrospectively. Results（1）There was a total of 82 liver cancer lesions detected in 14 patients with cirrhosis by using 128-slice spiral CT multi-phase contrast-enhanced scan. The lesion displayed a slightly lower density on plain scan, scan lesions in the ＂fast forward fast＂ typical enhancement, manifested as arterial phase enhancement, 3 lesions were not significantly enhanced arterial phase; portal phase gradually decreased, the delay period showed low density. Compared with the results of surgical pathology, the comprehensive detection rate of three stages of 64-slice 128-slice spiral CT multi-phase enhanced scan was as high as 100%.（2）The detection rate of three-phase dynamic enhanced CT scan of hepatocellular carcinoma by multi-slice spiral CT were as follows： the detection rate of arterial phase was 96.34%, the detection rate of portal phase was 82.92%, the detection rate of delayed phase was 87.80%. Conclusion In the clinical diagnosis of hepatocellular carcinoma, 64 rows of 128-slice spiral CT multi-phase enhanced scan can clearly reflect the characteristics of blood supply of hepatocellular carcinoma and provide a reliable imaging basis for the early diagnosis of hepatocellular carcinoma. Hepatocellular carcinoma diagnosis and disease monitoring has important clinical significance.