螺旋CT三期动态扫描与平扫在肝癌诊断中的应用价值研究

The Value of Spiral CT Threephase Dynamic Scan and Plain Scan in the Diagnosis of Liver Cancer

目的旨在探讨螺旋CT三期动态扫描与平扫在肝癌诊断中的应用价值。方法选取我院经病理学检查证实的78例肝癌患者作为研究对象,分析肝癌在CT平扫及三期增强扫描中的影像表现特征,比较两中检查对病灶的检出率。结果 78例患者中单发病灶者72例(93.58%),多发患者5例(6.41%),共89个病灶。76例(97.43%)患者CT平扫显示为低密度或等密度影,外观形态多呈现圆形或类圆形影;CT三期扫描结果显示,64例(82.05%)患者动脉期病灶快速增强,以高或等密度,呈点状、结节状或云絮状显著强化,病灶随时间强化持续存在且向中央扩散,其中48例(61.53%)为表现为均匀强化,16例(20.51%)为中强化,12例(15.38%)患者未见未强化,2例(2.56%)为不均匀强化;61例(78.20%)患者门脉期病灶密度迅速降低,低于肝实质密度;延迟期呈低密度改变,呈现典型的"快进快出"的影像学表现;CT平扫对肝癌病灶的检出率为83.14%(74/89),三期综合增强扫描对肝癌病灶的检出率为100%(89/89),CT平扫对肝癌病灶的检出率明显低于三期增强综合扫描(P<0.001)。结论螺旋CT三期动态扫描对肝癌的检出率高,可清楚显示肝癌典型的图像特征,为临床制定治疗方案提供可靠影像学资料。

Objective To investigate the value of spiral CT threephase dynamic scan and plain scan in the diagnosis of liver cancer.Methods 78 cases of liver cancer confirmed by pathology in 9 menstrual cycles in our hospital were selected as the subjects,to analyze the imaging features of liver cancer during CT noncontrast enhanced scan and three phase enhanced scan,compare the detection rate of the lesions between the two examinations.Results Of the 78 patients,72 cases were solitary lesions(93.58%),multiple lesions were in 5 cases(6.41%),there were 89 lesions.In 76 patients(97.43%),CT noncontrast enhanced scan showed low density or equal density shadow,the appearance of the shape of a circular or circular shadow.CT phasethree scan results show,in 64 patients(82.05%),the arterial phase lesions increased rapidly,marked by high or equal density,punctate,nodular or flocculent,the lesion persisted with time and diffused toward the center,48 of them(61.53%)showed homogeneous enhancement,16 cases(20.51%)were moderately strengthened.12 patients(15.38%)showed no enhancement,2 cases(2.56%)were inhomogeneous enhancement.In 61 patients(78.20%),the density of the portal phase decreased rapidly,lower than parenchymal density.The delayed phase showed low density change,presenting typical"fast forward,fast out"imaging findings,The detection rate of CT noncontrast enhanced scan for HCC was 83.14%(74/89),the detection rate of HCC in the three phase enhanced scan was 100%(89/89),the detection rate of CT noncontrast enhanced scan for liver cancer lesions was significantly lower than that of phase three enhanced integrated scan(P<0.001).Conclusion The three phase dynamic scan of spiral CT has high detection rate for liver cancer,which can clearly show the typical image features of liver cancer,and provide reliable imaging data for clinical treatment.