高速多排螺旋CT对≤2cm肝癌子灶的诊断的敏感性分析

Sensitivity of High-speed Multi-slice Spiral CT in the Diagnosis of Satellite Nodules ≤ 2cm of Hepatocellular Carcinoma

目的分析高速多排螺旋CT对≤2cm肝癌子灶的诊断敏感性。方法回顾性分析2013年4月-2016年10月我院64例经组织病理学证实为原发性肝癌伴子灶患者高速多排螺旋CT三期增强扫描数据,分析其影像表现并与CT扫描后5d内数字减影血管造影(DSA)结果进行对比分析,分析高速多排螺旋CT对≤2cm肝癌子灶诊断敏感性和影像学特征。结果高速多排螺旋CT共检测原发灶64个,子灶216个(左叶49个,右叶167个),≤2cm子灶181个(83.79%),<1cm子灶48个;DSA检测原发灶64个,子灶总数161个(左叶42个,右叶119个),其中≤2cm子灶119(73.91%),未检出<1cm子灶;CT子灶大小分布、平均子灶数目与DSA存在显著差异(P<0.05);CT平扫下,低密度肝癌子灶184个,等密度子灶22个;动脉期增强扫描显示轻度或明显强化肝癌子灶184个;平衡期显示低密度子灶211个,等密度子灶5个;有肝癌典型特征子灶173个;三期增强扫描始终无强化的低密度子灶37个;其中≤2cm子灶强化率76.24%;161个肝癌子灶DSA染色均明显,供血较好。结论高速多排螺旋CT对≤2cm肝癌子灶的诊断和检出较DSA有明显优势,尤其适于更小癌灶(<1cm)诊断和检出。

Objective To analyze the sensitivity of high-speed multi-slice spiral CT in diagnosis of satellite nodules≤2cm of hepatocellular carcinoma(HCC).Methods A total of 64 patients with HCC satellite nodules confirmed by histopathological examination in our hospital from April 2013-October 2016 were examined by high-speed multi-slice spiral CT three-phase contrast enhanced scanning.The results were compared with those of digital subtraction angiography(DSA)within 5 days after CT scanning.The sensitivity and imaging features of high-speed multi-slice spiral CT in diagnosis of HCC satellite nodules≤2cm were analyzed.Results There were 64 primary lesions,216 satellite nodules(49 satellite nodules in left lobe,167 satellite nodules in right lobe),181 satellite nodules(83.79%)≤2cm and 48 satellite nodules<1cm detected by high-speed multislice spiral CT.There were 64 primary lesions,161 satellite nodules(42 satellite nodules in left lobe,119 satellite nodules in right lobe),119 satellite nodules(83.79%)≤2cm and none nodules<1cm detected by DSA.There were significant differences in the size distribution and the average number of satellite nodules between CT and DSA(P<0.05).CT plain scan showed 184 low-density HCC satellite nodules and 22 equal-density HCC satellite nodules.Contrast-enhanced scan showed 184 mild or obviously enhanced HCC satellite nodules in arterial phase,211 low-density satellite nodules in balance phase,5 equal-density satellite nodules.There were 173 typical HCC satellite nodules.Threephase contrast-enhanced scan showed 37 satellite nodules without enhancement.The enhancement rate of satellite nodules≤2cm was 76.24%.DSA staining of 161 HCC satellite nodules was obvious,and the blood supply was good.Conclusion High-speed multi-slice spiral CT has obvious advantages over DSA in the diagnosis of HCC satellite nodules,especially suitable for diagnosis and detection of smaller tumors(<1cm).