Findings of non-pathologic perfusion defects by CT arterial portography and non-pathologic enhancement of CT hepatic arteriography

AIM To recognize the characteristic findings of non pathologic perfusion defects with CT arterial portography (CTAP) and nonpathologic enhancement found in CT hepatic arteriography (CTHA). METHODS The manifestations of nonpathologic perfusion defects with CTAP and non pathologic enhancement found in CTHA were analyzed in 50 patients with primary hepatocellular carcinoma. RESULTS The false positive rate of perfusion defects detected in CTAP was 15 1%. The shapes of perfusion defects were peripheral wedge, small, round, and patchy. The occurrence rate of non pathologic enhancement found in CTHA was 22 0%. The shapes of non pathologic enhancement were small, round, irregular, and wedge. CONCLUSION There was a high frequency of non pathologic perfusion defects detected with CTAP and non pathologic enhancement found in CTHA. The simultaneous use of both procedures may help decrease the false positive rate, and increase the veracity of diagnosis for hepatocellular carcinoma.

MSCT对原发性肝癌肝动脉化疗栓塞术后无碘油沉积区的血供研究及临床价值

目的采用多层螺旋CT（MSCT）平扫及双期增强扫描，研究原发性肝癌（HCC）经肝动脉化疗栓塞术（TACE）治疗后无碘油沉积区的血液供应，以判断TACE后疗效，并对制定进一步治疗方案提供有价值的信息。方法19例HCC患者（24个病灶），接受25次TACE后行MSCT平扫及增强双期扫描，根据动态增强表现将无碘油沉积区的血液供应分为四种类型：动脉供血型、门静脉供血型、双重供血型及少血供型。结果19例患者（24个病灶），经过25次TACE后无碘油沉积区的血供情况为：动脉供血型11个病灶（45．83％），双重供血型11个病灶（45．83％），乏血供型2个病灶（8．33％）；动脉期MSCTA中22个富血供型病灶中有18个病灶有明显的肿瘤供血动脉（81．8％），19例患者中发现寄生动脉5例，右膈动脉3例，胰十二指肠动脉1例，胸廓内1例。结论MSCT三期扫描及动脉期MSCTA可以很好地评价无碘油沉积区肿瘤病灶的供血情况，对判断TACE后疗效及制定进一步治疗方案有重要意义。

小儿肝母细胞瘤与肝细胞癌的CT及临床鉴别

目的:探讨肝母细胞瘤(HB)及儿童原发性肝细胞癌(HPC)的CT及临床特点,提高诊断水平。方法:回顾性分析经手术病例证实并行CT平扫及多期增强扫描的HB15例、HPC12例,患者的资料。对各项临床及CT观察指标进行统计学分析。结果:HB多见于肝右叶,肿块多较大,多见坏死囊变,钙化多见;HPC多累计肝左右两叶,巨块型及巨块结节型多见,钙化少见,可见门脉血栓及淋巴结肿大。平均发病年龄、乙肝病毒感染率、肝硬化发生率低于肝细胞肝癌。结论:肝母细胞瘤及肝细胞癌为小儿最常见的两大恶性肿瘤,在临床及CT表现均有各自的特点,将各自特点综合分析,可在一定程度上将两者鉴别。