应用DCE-MSCT扫描鉴别诊断小肝癌及肝硬化再生结节的可行性研究

Feasibility of DCE-MSCT Scans in the Differential Diagnosis of Small Liver Cancer and Hepatic Cirrhosis Regenerative Nodule

目的分析应用动态增强一多层螺旋CT(DCE-MSCT)扫描鉴别诊断小肝癌及肝硬化再生结节的可行性。方法选取本院2017年5月至2018年11月收治的27例小肝癌和30例肝硬化再生结节患者作为研究对象,分析小肝癌与肝硬化再生结节大小、形态、密度及CT动态增强分型等征象,比较两者不同扫描时相的CT值。结果小肝癌平扫期、静脉期、延迟期的CT值低于肝硬化再生结节,动脉期CT值明显高于肝硬化再生结节,两者静脉期、动脉期CT值比较有差异(P<0.05)。27例小肝癌患者共发现36个癌结节,最小直径1.46cm,最大直径2.98cm。DCE曲线呈“高容低阻型”19例,“低容低阻型”6例,“不典型阻型”2例;30例肝硬化再生结节CT平扫呈等密度或表现为肝实质不均匀,DCE曲线呈“低容等阻型”15例,“等容等阻型”11例,“不典型阻型”4例。结论DCE-MSCT可清晰显示小肝癌与肝硬化再生结节的血流动力学特点,两者的动态增强CT结果存在一定差异,故采用DCE-MSCT可有效鉴别小肝癌与肝硬化再生结节。

Objective To analyze the feasibility of dynamic contrast enhancement-multi-slice spiral CT(DCE-MSCT)scans in the differential diagnosis of small liver cancer and hepatic cirrhosis regenerative nodule.Methods 27 patients with small liver cancer and 30 patients with hepatic cirrhosis regenerative nodule who were treated in our hospital from May 2017 to November 2018 were selected as the research objects.The Signs of small liver cancer and hepatic cirrhosis regenerative nodule such as signs,size,shape,density,and typing of CT dynamic contrast enhancement were analyzed.The CT values of them in different scanning phases were compared.Results The CT value of small liver cancer in plain scan,venous phase,and delayed phase was lower than that of hepatic cirrhosis regenerative nodule,while the CT value in arterial phase was significantly higher than that of hepatic cirrhosis regenerative nodule.There was difference in CT values between them in venous and arterial phases(P<0.05).36 cancerous nodules were found in 27 patients with small liver cancer,with minimum diameter of 1.46 cm and maximum diameter of 2.98 cm.The DCE curve showed"high-capacitance and low-resistance"in 19 cases,"low-capacitance and low-resistance"in 6 cases,and"atypical-resistance"in 2 cases.CT plain scans of 30 patients with hepatic cirrhosis regenerative nodule showed equal density or nonuniform liver parenchyma.The DCE curve showed in"low-capacitance and constant resistance"15 cases,"equal-capacitance and constant resistance"11 cases,and"atypical resistance in 4 cases.Conclusion DCE-MSCT can clearly show the hemodynamic characteristics of small liver cancer and hepatic cirrhosis regenerative nodule.There are some differences in the results of dynamic enhanced CT between them.Therefore,DCE-MSCT can effectively distinguish small liver cancer from hepatic cirrhosis regenerative nodule.