小肝癌的碘油CT研究

Lipiodol CT Study of Small Hepatic Carcinoma

探讨碘油ＣＴ对小肝癌诊断及鉴别诊断和临床应用价值。材料和方法：临床诊断肝癌或肝癌术后复发、超声、平扫及增强ＣＴ检查肝内病灶最大径≤３ｃｍ患者５６例。经股动脉插管肝动脉造影后注入碘油４～１２ｍｌ。１－４周后作ＣＴ扫描，根据ＣＴ检查结果作出前瞻性诊断并和手术病理结果对照。结果：５６例共发现１３１个病灶。其中肝癌病灶１０９个，血管瘤１２个，其它１０个。在１０９个小肝癌病灶中四种影像方法检出率分别为超声７０．６％，ＣＴ６１．５％，血管造影６１．５％，碘油ＣＴ８５．３％。诊断特异性分别为６８．８％，８３．５％８２．１％和９２．５％。碘油ＣＴ均明显为优。结论：本研究显示碘油ＣＴ是目前诊断小肝癌最敏感和准确的影像方法之一。

Purpose:This paper studied the capability of diagnosis and difference diagnosis in small hepatic carcinoma by lipiodol CT (LpCT). The value of LpCT used in clinical was discussed. Materials and Methods: 56 patiens with suspected small hepatic tumor or postoperation recurrence were diagnosis in clinic. All lesions of liver were less than 3cm in diameter detected by US, pre-and post-contrast CT. CT scaned after 1-4 weeks by transcatheter hepatic arterial lipoidol injecting 4-12ml. The result of LpCT was prospectively studied and compared with operation and pathology.Results: 56 patients had been finded 131 focal lesions in total. There were 109 foci of hepatoma, 12foci of hemengiomas and 10 foci of other lesions. In 109 hepatic tumor detection rate by US was 70.6%, CT 61.5%, angiography 61.6%, LpCT 85.3%. The specificity of four methods diagnosis wre US 68.8%,CT 83.55, angiography 82.1%, LpCT 92.5%, LpCT was higher apparently than other.Conclusion: This study showed that LpCT was one of most sensitive and specific imaging methods in diagnosis small hepatic tumor.