64例原发性肝细胞癌的CT扫描与血管造影影像分析

CT Scan and Angiographic Analysis of 64 Cases of Primary Hepatocellular Carcinoma

目的:探讨分析64例原发性肝细胞癌的CT扫描与血管造影影像特点。方法:选取2019年1月~2020年1月间我院临床及手术病理确诊的64例原发性中晚期肝细胞癌患者,施以CT扫描及血管造影,观察对比两种方法的特点。结果:CT扫描病灶检出准确率明显低于血管造影,(P<0.05);两种方法检出结节型及弥漫型肝细胞癌差异无统计学意义(P>0.05);检出巨块型肝细胞癌时,血管造影检出数明显高于CT扫描,差异有统计学意义(P<0.05);CT扫描未显示的小子灶有10例,未显示的动-静脉瘘有3例,而血管造影均有显示;CT扫描显示等密度病灶1例,低密度病灶63例,血管造影显示多血管型患者57例,少血管型患者7例。结论:CT扫描的特征征象为低密灶内结节影,大量新生血管形成、动-静脉瘘及动脉形态特征为血管造影表现特点,血管造影病灶检出准确率及巨块型肝细胞癌检出率高于CT扫描,两种方法联用可为原发性肝细胞癌诊断提供依据。

Objective:To investigate the CT and angiographic features of 64 cases of primary hepatocellular carcinoma.Methods:From January 2019 to January 2020,64 patients with advanced hepatocellular carcinoma diagnosed by clinical and surgical pathology in our hospital were selected.CT scan and angiography were performed to observe and compare the characteristics of the two methods.Results:The detection accuracy rate of CT scanning was significantly lower than that of angiography(P<0.05);there was no significant difference between the two methods in detecting nodular and diffuse hepatocellular carcinoma(P>0.05);when detecting massive hepatocellular carcinoma,the detection number of angiography was significantly higher than that of CT scanning,and the difference was statistically significant(P<0.05);there were 10 cases of small lesions and 3 cases of arteriovenous fistula that were not shown by CT scan CT scan showed 1 case of equal density lesions,63 cases of low density lesions,57 cases of multi vessel type and 7 cases of hypovascular type.Conclusion:The characteristic sign of CT scan is low density nodule shadow,a large number of neovascularization,arteriovenous fistula and arterial morphology are the angiographic features.The detection accuracy of angiographic lesions and the detection rate of massive hepatocellular carcinoma are higher than those of CT scanning.The combination of the two methods can provide the basis for the diagnosis of primary hepatocellular carcinoma.