双源螺旋CT单期扫描及多期联合扫描对原发性肝细胞癌病灶的检出能力

Detection capabilities of dual-source spiral CT single-phase scan and multi-phase scan for primary hepatocellular carcinoma lesions

目的探讨双源螺旋CT单期扫描及多期联合扫描对原发性肝细胞癌病灶的检出能力。方法回顾性分析133例原发性肝癌患者(共138个病灶)的双源螺旋CT检查资料,根据肝内最大肿瘤直径将患者分为A组(肿瘤直径≤3 cm) 31例(共36个病灶),B组(3 cm <肿瘤直径<5 cm) 36例(共36个病灶),C组(肿瘤直径≥5 cm) 66例(共66个病灶)。记录3组患者平扫期及增强各期显示的病灶数以及任意三期联合扫描检出的病灶数,计算病灶检出率。结果 A、B组中平扫期、动脉期、门静脉期、平衡期间病灶检出率比较,差异均无统计学意义(均P> 0. 05),C组各期的病灶检出率均为100%。A组患者任意三期联合扫描的病灶检出率比较,差异均无统计学意义(均P> 0. 05),B组及C组患者任意三期联合扫描病灶检出率均为100%。结论减少肝脏CT检查中的一期并不影响肝癌病灶的检出率。对于病灶直径≤3 cm的肝癌患者,建议减少平扫期,采用动脉期+门静脉期+平衡期检查。

Objective To explore detection capabilities of dual-source spiral CT single-phase scan and multi-phase scan for primary hepatocellular carcinoma lesions.Methods Dual-source spiral CT data of 133 patients with primary hepatocellular carcinoma(totally 138 lesions)were retrospectively analyzed.Patients were divided into group A(tumor diameter≤3 cm,n=31,and totally 36 lesions),group B(3 cm<tumor diameter<5 cm,n=36,and totally 36 lesion),or group C(tumor diameter≥5 cm,n=66,and totally 66 lesion)according to the diameter of the maximal intrahepatic tumor.The amounts of the lesions displayed by the plain scan and various enhancement scans,and the lesions jointly detected by any three phases were recorded,then the detection rates for lesions were calculated.Results In group A or group B,there was no statistical difference in the detection rate for lesions among the plain phase,arterial phase,portal vein phase,and balance phase(all P >0.05),and the detection rate of each phase for lesions was 100%in group C.In group A,there was no statistical difference in the detection rate for lesions among combined scanning schemes of any three phases(all P >0.05),and the detection rates of combined scanning schemes of any three phases for lesions were 100%in group B and C.Conclusion Reduction of any phase of liver CT has no effect on detection rate for hepatocellular carcinoma lesions.For the hepatocellular carcinoma patients with the lesion diameter≤3 cm,it is suggested that the plain scan can be eliminated and the detection with arterial phase+portal phase+balanced phase should be adopted.