Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection

BACKGROUND Recurrence is the major challenge facing endoscopic submucosal dissection(ESD)-based treatment therapies for early gastric cancer(EGC).Urgent development of simple and easy surveillance approaches will enhance clinical treatment of the disease.AIM To explore the role of computed tomography(CT)recurrence in evaluating EGC after ESD treatment.METHODS We retrospectively recruited patients from our endoscopy department,between January 2002 and December 2015,and analyzed their basic characteristics,including symptoms,CT results,and results of endoscopy with biopsy,among others.RESULTS Among a total of 2150 patients EGC patients surveyed,1362 met our inclusion and exclusion criteria and were therefore enrolled in our study.The cohort’s sensitivity of CT for recurrent GC and specificity were 44.22%and 43.86%,respectively,with negative and positive predictive values of 40.15%(275/685)and 48.01%(325/677),respectively.The area under the curve of arterial and venous CT values for recurrent EGC were 0.545,and 0.604,respectively.Receiver operating characteristic curve revealed no statistically significant differences between arterial and venous CT values for recurrent EGC.CONCLUSION Enhanced CT has superior diagnostic efficacy,but less accuracy,compared to gold standard techniques in patients with recurrent EGC.

Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps,and gastric stromal tumor risk stratification assessment

BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of transformation into malignant tumors is as high as 20%-30%.AIM To investigate the value of multi-slice spiral computed tomography(MSCT)in the differential diagnosis of GST and benign gastric polyps,and GST risk stratification assessment.METHODS We included 64 patients with GST(GST group)and 60 with benign gastric polyps(control group),confirmed by pathological examination after surgery in PLA General Hospital,from January 2016 to June 2021.The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared.According to the National Institutes of Health’s standard,GST is divided into low-and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values.RESULTS The incidences of extraluminal growth,blurred boundaries,and ulceration in the GST group were significantly higher than those in the control group(P<0.05).The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group(P<0.05).The MSCT differential diagnosis of GST and gastric polyp sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and areas under the curve(AUCs)were 73.44%,83.33%,26.56%,16.67%,0.784,respectively.The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value,with a statistical difference.The results showed that the sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%,62.20%,19.82%,37.80%,and 0.710,respectively.The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%,60.40%,32.37%,39.60%,and 0.710,respectively.The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group(P<0.05).The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group(P<0.05).CONCLUSION Presurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.

Multi-slice spiral computed tomography in diagnosing unstable pelvic fractures in elderly and effect of less invasive stabilization

BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.

Multi-slice computerized tomography critical role in transcatheter aortic valve implantation plan: Review of current literature

Transcatheter aortic valve implantation(TAVI) has been shown in improve outcome of severe aortic stenosis(AS) patients, deemed surgical high-risk or inoperable, and has grown popular in the past decade. The procedure requires accurate prior planning, and demands an integration of a "Heart Team" consisted from cardiac surgeons, interventional cardiologists, and imaging experts. The role of cardiac imaging and especially multi-slice computerized tomography(MSCT) has been a mainstay of pre-evaluation of severe AS patients that allows to accurately depict and size the cardiac and vascular structures, and has become the primary tool for procedural planning. This article is aimed to evaluate current uses of MSCT in severe AS patients undergoing TAVI, delineate the various measurements derived from this modality and review current literature regarding it's advantages over other techniques.

Validation of a novel imaging approach using multi-slice CT and cone-beam CT to follow-up on condylar remodeling after bimaxillary surgery

The main goal of this study was to introduce a novel three-dimensional procedure to objectively quantify both inner and outer condylar remodelling on preoperative multi-slice computed tomography （MSCT） and postoperative cone-beam computed tomography （CBCT） images. Second, the reliability and accuracy of this condylar volume quantification method was assessed. The mandibles of 20 patients （11 female and 9 male） who underwent bimaxillary surgery were semi-automatically extracted from MSCT/CBCT scans and rendered in 3D. The resulting condyles were spatially matched by using an anatomical landmark-based registration procedure. A standardized sphere was created around each condyle, and the condylar bone volume within this selected region of interest was automatically calculated. To investigate the reproducibility of the method, inter- and intra-observer reliability was calculated for assessments made by two experienced radiologists twice five months apart in a set of ten randomly selected patients. To test the accuracy of the bone segmentation, the inner and outer bone structures of one dry mandible, scanned according to the clinical set-up, were compared with the gold standard, micro-CT. Thirty-eight condyles showed a significant （P〈O.05） mean bone volume decrease of 26.4%_ 11.4% （502.9 mm3＋ 268.1 mm3）. No significant effects of side, sex or age were found. Good to excellent （ICC〉 0.6） intra- and inter-observer reliability was observed for both MSCT and CBCT. Moreover, the bone segmentation accuracy was less than one voxel （0.4 mm） for MSCT （0.3 mm __. 0.2 mm） and CBCT （0.4 mm _ 0.3 mm）, thus indicating the clinical potential of this method for objective follow-up in pathological condylar resorption.

MSCT在自发性孤立性肠系膜上动脉夹层诊断中的特点

目的:探讨MSCT在自发性孤立性肠系膜上动脉夹层(SISMAD)诊断中的特点。方法:回顾分析2018年6月-2021年12月间苏州市相城人民医院与苏州大学附属第二医院收治的86例SISMAD患者(苏州大学附属第二医院77例,苏州市相城人民医院9例)的CT影像及临床资料。分析SISMAD发生部位、管径大小、管腔密度、管周脂肪浸润及CT增强特点,提炼SISMAD CT平扫及增强特征。结果:86例SISMAD发生在肠系膜上动脉垂直部上端68例、管周晕征:45例(约52.3%)、管腔密度增高:44例(约51.2%);86例SISMAD患者,Ⅰ型31例,Ⅱ型17例,Ⅲ型12例,Ⅳ型26例。结论:CT平扫肠系膜上动脉管径增粗、管周晕征提示SISMAD的可能性,进一步增强CT可明确诊断。

Portal vein computed tomography imaging characteristics and their relationship with bleeding risk in patients with liver cirrhosis undergoing interventional therapy

BACKGROUND This study aimed to analyze the predictive value of multi-slice spiral computed tomography(CT)perfusion imaging for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension.A total of 62 patients with cirrhotic portal hypertension and 28 healthy individuals were included.The results showed that multi-slice spiral CT perfusion imaging had a significant predictive value for upper gastrointestinal bleeding in patients with cirrhotic portal hypertension.The vascular area,number of vascular cross-sections,and gastric coronary vein diameter(GCVD)showed high predictive values,with the vascular area having the best predictive value.AIM To investigate the predictive accuracy of multi-slice spiral CT perfusion imaging for upper gastrointestinal bleeding in patients with cirrhosis and portal hypertension.METHODS This study included 62 patients with cirrhotic portal hypertension(disease group)and 28 healthy individuals(control group).The disease group was further divided into two subgroups:Group A(n=27,bleeding)and group B(n=35,no bleeding).All patients underwent multi-slice spiral CT perfusion imaging at our hospital,and we compared various parameters such as liver blood flow,vein size,number of blood vessels,and blood vessel area between the two groups.We employed statistical analysis to identify factors associated with upper gastrointestinal bleeding and created a graph comparing the predictive value of different factors for bleeding.RESULTS We found no difference in hepatic artery(HAP)levels among the three groups(all P>0.05).The portal vein levels in groups A and B were much lower than in the control group;group A was much lower than group B(all P<0.05).The HAP perfusion index levels in groups A and B were much higher than in the control group;group A was much higher than group B(all P<0.05).The portal vein diameter,splenic vein diameter,and GCVD levels in groups A and B were much higher than in the control group;those in group A were much higher than those in group B(all P<0.05).The number of blood vessels and blood vessel area in groups A and B were much higher than in the control group;those in group A were much higher than those in group B(all P<0.05).The statistical method showed a strong link between GCVD,number of blood vessels,blood vessel area,and upper gastrointestinal bleeding(odds ratio=1.275,1.346,1.397,P<0.05).The graph showed that GCVD,number of blood vessels,and blood vessel area could predict bleeding well,with blood vessel area having the best prediction power.CONCLUSION That multi-slice spiral CT perfusion imaging can predict upper gastrointestinal bleeding well in patients with cirrhosis and high blood pressure in the portal vein.GCVD,number of blood vessels,and blood vessel area had high prediction power.The blood vessel area had the best prediction power,with an area under the curve of 0.831.

晚期胃癌HER2表达与MSCT多参数影像表现相关性分析

目的:探讨人表皮生长因子受体-2(HER2)在晚期胃癌患者中的表达与MSCT多参数影像表现的相关性。方法:回顾性分析2017年6月至2021年12月期间62例晚期胃癌患者临床资料及MSCT扫描资料,根据HER2表达情况的免疫组化结果,晚期胃癌患者分为HER2阴性组47例(75.8%)和HER2阳性组15例(24.2%)。先采用卡方检验对临床病历资料(年龄、性别、分化程度、Lauren分型)及CT多参数影像表现数据(肿瘤部位、厚度、大小、强化方式、强化程度、是否淋巴结转移、是否肝转移及是否腹膜转移)进行分析,再将有统计学意义的因素用Logistic回归进行分析,计算优势比(dominance ratio,OR)。结果:明显强化、是否肝转移、是否腹膜转移,两组间差异具有统计学意义(P<0.05)。年龄、性别、分化程度、Lauren分型、肿瘤部位、厚度、大小、强化方式、是否淋巴结转移在两组间差异无统计学意义(P>0.05)。Logistic回归分析显示,明显强化(OR=8.214)、肝脏转移(OR=6.244)与HER2阳性有关(P<0.05)。结论:与HER2阴性胃癌相比,HER2阳性胃癌表现强化程度(明显强化)、肝脏转移,具有一定潜在的临床应用参考价值。

儿童肾母细胞瘤的MSCT诊断

目的探讨儿童肾母细胞瘤的MSCT表现特点,以期提高影像诊断准确率。方法回顾性分析45例经手术及病理证实为肾母细胞瘤的患儿资料,男23例,女22例,最小年儿童肾母细胞瘤多见于4岁以下儿童,最小年龄为3个月,最大年龄为11岁,平均2.9岁;采用Philips Brilliance 16,先予平扫,再使用2ml/kg造影剂欧乃派克静脉团注后立即扫描,并行多平面重建(MPR)及最大密度投影(MIP)重建。结果全部为密度不均匀肿块,单侧多见,上极多于下极,肿瘤不均匀强化,常伴坏死、出血,少数有钙化;残存肾呈新月形强化为典型CT表现,肿块可跨过中线,但不包绕腹膜后大血管;腹膜后、膈脚后淋巴结转移最多见。MPR、MIP重建可清晰显示血管受累情况。结论儿童肾母细胞瘤多见于4岁以下儿童,MSCT表现有一定的特点,肿瘤呈不均匀强化,残存肾呈新月形强化为其典型表现,有助于本病的诊断。

肺癌MSCT灌注成像与病理分型的相关性研究

目的:对肺癌MSCT灌注成像及相关灌注参数进行分析,研究肺癌MSCT灌注成像与病理类型之间的关系,探讨其临床应用价值。方法:对32例肺癌患者,先行常规CT扫描,确定肿瘤的中心层面,然后采用电影技术对肿瘤中心层面进行连续扫描,以获得该层面内组织的时间-密度曲线,计算出血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面渗透性(PS),以此评价肿瘤灌注情况,并与病理分型进行对比分析。结果:中心型肺癌与周围性肺癌各灌注参数均无明显差异(P>0.05)。对各型肺癌的灌注参数进行分析得出:各型肺癌BF、PS值大小关系为鳞癌<腺癌(P<0.05),鳞癌<小细胞癌(P<0.05),腺癌BF、PS值小于小细胞癌但两者之间的差异无统计学意义(P>0.05);各型肺癌BV值大小顺序为鳞癌<腺癌<小细胞癌(P<0.05);各型肺癌MTT值之间无明显差异。结论:肺癌MSCT灌注成像反映各型肺癌血流特点及肿瘤内部微血管密度变化,有利于肺癌病理分型诊断。

肺硬化性血管瘤的MSCT诊断

目的:探讨肺硬化性血管瘤的MSCT表现特点,以期提高影像诊断准确率。方法:回顾性分析19例经手术及病理证实的肺硬化性血管瘤的患者资料,女性18例,男性1例,平均年龄为52.5岁;采用16层螺旋CT扫描仪,120kV,160 mAs,层厚5mm,层间距5mm,高压团注非离子型对比剂100ml(300mg/ml)增强扫描,流速2.5ml/s,延迟30s扫描,回顾性1.5mm薄层重建及多平面重组(MPR)分析。结果:全部为单发实性类圆形肺结节或肿块,最大径67mm,平均直径23mm,分布无偏向性,边界清晰。8例(42.1%)见斑点状钙化灶,4例(21.1%)见分叶征,3例(15.8%)见空气新月征,4例(21.1%)病灶跨叶间胸膜生长,1例(5.26%)见胸膜牵拉凹陷,8例(80%)增强CT扫描均显示贴边血管征。结论:肺硬化性血管瘤多见于中年女性,表现为肺内单发结节或肿块,MSCT表现有一定的特点,病灶可跨叶间裂生长,明显强化及贴边血管征有助于本病的诊断。

MSCT诊断先天性肺静脉异位引流临床价值

目的评价多排螺旋CT(MSCT)血管造影在先天性肺静脉异位引流中的临床价值。方法收集2005年至2009年94例MSCT诊断的肺静脉异位引流患者,其中78例经手术证实,(男性40例,女性38例)进行回顾性分析,并将CT诊断结果与术后诊断对照。结果 78例行手术治疗的肺静脉异位引流病例中,完全性肺静脉异位引流者共29例,其中心上型7例、心脏型14例、心下型3例、混合型5例;部分性肺静脉异位引流者共49例。与术后诊断相比,诊断正确符合率100%。结论 MSCT诊断肺静脉异位引流具有极高的诊断准确率,是一种很好的无创检查方法,一次检查不仅解决心内结构连接异常外,还可同时了解合并畸形或其它并发症的诊断问题,对外科医师的手术处理有良好的指导作用。

64层MSCT在小儿支气管异物诊断中的应用价值

目的探讨64层螺旋CT(MSCT)三维图像后处理技术在小儿支气管异物诊断中的应用价值。方法回顾性分析本院14例支气管异物患儿64层MSCT的影像学资料,所有病例经MSCT横断位扫描,并行多平面重建(MPR)、曲面重建(CPR)、容积重现(VR)和CT仿真内镜(CTVE)三维图像后处理。结果 14例支气管异物患儿,异物为米粒4例,花生衣1例,开心果2例,瓜子仁2例,果冻2例,葡萄干1例,不明异物2例。异物发生部位在右主支气管开口处5例,右主支气管5例,右下支气管1例,左主支气管3例。64层MSCT三维图像后处理技术能够准确地显示异物的位置、形态及大小,有异物所引起的支气管的狭窄和异物阻塞产生的间接征象。结论 64层MSCT三维图像后处理技术能准确、直观地显示支气管异物,对小儿呼吸道异物的诊断和鉴别诊断具有非常重要的价值。

MSCT对消化道枣核异物的诊断价值

目的：探讨MSCT对消化道枣核异物的诊断价值。方法回顾性分析2015年1月～2015年11月在宁波市第二医院影像科行MSCT平扫检查诊断消化道枣核异物患者的临床和影像资料33例，异物的性质、部位以及并发症均得到内镜或手术证实。结果1）异物部位：食管6例，胃窦9例，小肠12例，结肠和直肠各3例；2）横断面显示异物的形态：圆形1例，梭形32例；3）异物内部结构：中空24例，密实9例；4）并发症：消化道穿孔12例，肠梗阻9例。结论 MSCT对消化道枣核异物的部位、性质及并发症的诊断敏感且准确，为临床制定治疗方案有很大帮助。

肾脏恶性肿瘤的MSCT灌注研究

目的 :探讨多层螺旋CT(MSCT)灌注成像技术在肾脏恶性肿瘤中的初步应用。 方法 :对 2 7例经手术病理证实的肾脏恶性肿瘤和 5 5例健康体检者进行多层螺旋CT增强后灌注扫描及平衡期全肾螺旋扫描 ,将所得数据送入AdvancedWorkstation 4 .0工作站 ,应用perfusion 2软件得到灌注参数。 结果 :(1)肿瘤生长活跃部分的灌注参数血流量 (BF)、血容量 (BV)、对比剂平均通过时间 (MTT)和毛细血管表面通透系数 (PS)与对照组肾皮质和肾髓质的灌注参数间差异均有统计学意义 (P <0 .0 5 )。 (2 )对照组肾皮质、肾髓质的灌注参数与健侧肾皮质、肾髓质的灌注参数间的差异无统计学意义 (P >0 .0 5 )。 结论 :MSCT灌注成像可同时反映恶性肿瘤的形态和功能变化 ,作为一种方便、无创、可重复多次使用的检查方法 ,MSCT灌注成像将有广泛的应用前景。

机化性肺炎的MSCT征象分析

目的分析机化性肺炎的MSCT影像学表现及特征。方法回顾分析24例经手术病理证实的机化性肺炎的CT影像学表现。结果 24例中,12例表现为肺叶、肺段的实变影,8例病灶中有含气支气管征及支气管血管束异常;6例病灶呈结节样,其中4例边界清楚,轮廓不规则,伴有毛刺样结构,另2例结节密度不均匀;6例呈肿块影或团块影,病灶边缘与肺交界面模糊,可见晕征,其中3例病灶中央小空洞形成。24例病例中有18例胸膜增厚粘连。结论机化性肺炎有一定的影像学特点,MSCT扫描有利于这些特征的显示;但仍有部分影像表现难以与其他病变相鉴别,最终需病理组织学检查。

小肠梗阻MSCT研究现状

小肠梗阻具有很高的发病率,早期准确诊断和全面病情评估是临床选择治疗方式的前提。多层螺旋CT(MSCT)在评价是否存在小肠梗阻、梗阻部位、严重程度及梗阻病因方面均具有很高的准确度,对继发性肠缺血也能提供有价值的影像学信息。本文对MSCT在小肠梗阻评价中的应用现状进行综述。

冠状动脉-肺动脉瘘的MSCT诊断价值和征象分析

目的探讨冠状动脉-肺动脉瘘（CPF）的多层螺旋CT（MSCT）诊断价值和征象分析。方法回顾性分析16例确诊为CPF患者的临床和CT影像资料,其中男性11例,女性5例,平均年龄56.4岁。观察瘘血管起源、走行和分布,瘘口位置、大小及征象（穿通征、射血征和浓染征）,肺动脉增宽与否。结果 16例CPF中,右圆锥支1例,右冠状动脉供血9例（56.3%）,左冠状动脉供血4例（25.0%）,左右冠状动脉同时供血2例（12.5%）;2例瘘口为2个,14例瘘口为1个;瘘口位于主肺动脉左侧壁12例、前壁4例;肺动脉瘘口大小约1.2-5.0 mm。MSCT直接征象：穿通征16例（100.0%）;射血征7例（43.8%）,均在75%期相显示;浓染征10例（62.5%）,8例在45%期相显示,2例在75%期相显示。间接征象：表现为瘘血管增粗、迂曲,部分呈蚯蚓状改变,贴附于肺动脉表面,其中5例合并动脉瘤。肺动脉增粗4例,瘘口大小约3.8-6.9 mm,平均瘘口大小为4.8 mm。结论MSCT结合三维重组技术对诊断CPF具有极高的临床价值,可作为首选的检查方法。

MSCT对T_1和T_2期非小细胞肺癌患者纵隔淋巴结转移的诊断意义

目的:评估胸部多层CT扫描(MSCT)对T1和T2期非小细胞肺癌(NSCLC)纵隔淋巴结转移的指导意义。方法:选择2004年3月至2012年3月T1和T2期NSCLC患者32例,依据病理结果分析术前MSCT对纵隔淋巴结的判断。结果:以淋巴结短径≥10 mm MSCT评价纵隔淋巴转移的敏感性和特异性分别为82.4%和92.4%;淋巴结大小、原发肿瘤位置及脏胸膜侵犯对纵隔淋巴转移的预测差异均有统计学意义(P<0.05)。结论:淋巴结大小可作为评估NSCLC患者纵膈淋巴结转移的依据,原发于右肺的肿瘤及肿瘤伴有脏层胸膜侵犯具有较高的纵隔淋巴结转移风险。

探讨MSCT对肝细胞癌合并动静脉分流的诊断价值

目的探讨肝细胞癌合并AVS（包括HAPVS和HAHVS）的MSCT影像学表现，评价MSCT在AVS诊断中的价值．方法回顾性分析298例HCC患者中的68例合并AVS患者的MSCT表现．所有患者采用Siemens Sensation16层螺旋CT行动态增强扫描，动脉期延迟20～25S，静脉期延迟55～60S，将采集的薄层图像传到Wizard工作站进行血管重建，部分病例采用SSD，VRT，MIP技术，部分采用MPR技术．结果门静脉主干和／或1级分支提早显影，或显影密度大于肠系膜上动脉／脾动脉者，属于中央型（n=15）；门静脉2级和／或以下分支提早显影，或显影密度大于上1级分支者，属于周围型-Ⅰ型（n=18）；一过性肝实质强化者，属于周围型-Ⅱ型（n=32）；4例HAHVS HCC病灶内粗大迂曲引流静脉汇集至肝静脉，肝静脉提早增强、浓密显影．SSD，VRT和MIP对中央型AVS显示率达100％，在显示能力上无统计学意义；在周围型-Ⅰ型上，SSD的显示能力不及VRT和MIP，VRT和MIP在统计学上无差异；对于周围型-Ⅱ型，3种技术显示均较低，无法用来评估，补充采用MPR，MPR对THPE的显示能力达100％．结论HCC合并AVS具有多种复杂的表现形式，CTA可以弥补CT横轴位的不足，二者结合，明显提高了AVS的诊断和鉴别诊断能力．