ISSN 1004-4140
CN 11-3017/P

螺旋CT多期扫描在肝小血管瘤与小肝癌诊断中的临床应用

Clinical Application of More-phase Spiral CT in Small Hepatocellular Carcinoma and Small Hepatic Hemangioma

  • 摘要: 目的:探讨小肝细胞癌和肝脏小血管瘤螺旋CT增强表现及其随时间延迟所致的CT征象的变化过程。材料与方法:50例患者(15例SHCC,35例SHHE),其中19例经手术病理标本证实,其余患者由临床表现和实验室检查诊断。采用Siemens Plus4C螺旋CT机,先作平扫,然后在肿瘤靶平面平衡期扫描。着重观察、分析不同CT扫描时相小肝细胞癌和肝脏小血管瘤CT表现特征的动态变化过程。结果,SHHE组发现病灶44个,30个病灶在动脉期边缘明显强化逐渐向中心填充,22个病灶在动脉期和门静脉期均为高密度,2个病灶在动脉期和门静脉期均为低密度。在平衡期42个病灶SHHE为高密度和等密度;SHCC组发现病灶18个,14个病灶SHCC显示动脉期呈高密度、门静脉期为低密度,3个病灶动脉期为高密度、门静脉期为等密度,1个病灶动脉期、门静脉期均为低密度,平衡期16个病灶的SHCC为低密度。结论:根据SHHE和SHCC在螺旋CT多期扫描的强化表现,大多数病例可明确两者诊断。

     

    Abstract: Objective: To investigate the enhanced spiral CT features of SHCC and SHHE,and the changing of these features with time. Materials and Methods: of 50 cases with SHCC(15/50)and SHHE (35/50), 19 cases were surgically and pathologically proved, and the others were clinically diagnosed. Plain scanning, single-level dynamic scanning of the target section during hepatic arterial phase (delaying 25-30 sec.), portal venous phase scanning(delaying 60-70 sec.)of the whole liver, and equilibrium scanning of the target section here performed. The dynamic changes of CT features were observed and analyzed. Results: 35 cases with SHHE were found in 44 focuses. Peripheral enhancement significantly of the lesion were found 30(30/44) focuses on the arterial phase scan and to fill up by degrees from the periphery of the lesion to center. Hemogenous enhancement was seen in 22(22/44) focuses and 2(2/44) focuses did not showed enhance-ment on the arterial phase and the portal venous phase scan. 42(42/44)cases with SHHE showed high or equal density compare with the liver density on the equilibrate phase scan. 15 cases with SHCC were found in 18 focus. Hemogenous enhancement was seen in 14 (14/18) focuses on the arterial phase scan and did not showed enhance-ment on the portal venous phase scan. 2(2/18) cases with SHHE showed hemogenous or no hemogenous enhancement on the equilibrate phase scan. 16(16/18) cases with SHCC showed low density compare with the liver density on the equilibrate phase scan. Conclusion: According to the enhanced spiral CT features and the changing of these features with time, the most of SHCC and SHHE were diagnosed.

     

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