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目的 评价螺旋CT扫描的动脉期、静脉期以及双期联合应用对小肝癌的诊断价值。方法 对 2 7例小肝癌行螺旋CT双期增强扫描 ,增强动脉期于造影剂注射后 2 5～ 30s开始扫描 ,静脉期于 6 5～ 70s开始扫描 ,造影剂注射速率为 2 .5～ 3.0ml/s,用量 70～ 85ml。结果 2 7例小肝癌共发现 34个结节病灶。平扫、动脉期、静脉期、动静脉双期的检出率分别为 70 %、91%、79%、94% ,经统计学分析 ,动脉期和动静脉双期的检出率较平扫和静脉期高 (Ρ <0 .0 5 ) ,动脉期和动静脉双期间、平扫和静脉期间比较均无统计学意义 (Ρ >0 .0 5 )。 6 5 % (2 2 / 34 )的小肝癌动脉期呈均匀高密度 ,与同期肝组织比较 ,CT值平均增加 2 5 .9± 14.4HU ;2 3%(8/ 34 )呈不均匀高密度。 79%静脉期呈低密度 ,与同期肝组织比较 ,CT值平均减少 18.7± 8.9HU ;2 1% (7/ 34 )为等密度。双期扫描的定性准确率为 97% (31/ 32 )。结论 螺旋CT动、静脉双期扫描对小肝癌诊断有很高的敏感性和特异性。
Objective To evaluate the diagnostic value of spiral CT in the diagnosis of small hepatocellular carcinoma (HCC). Methods Twenty-seven patients with small hepatocellular carcinoma underwent spiral CT double-phase contrast-enhanced scanning. The contrast-enhanced scanning was started at 25 to 30 seconds after contrast medium injection. The venous phase was scanned at 65 to 70 seconds. The injection rate of contrast medium was 2.5-3.0 ml / s, dosage 70 ~ 85ml. Results A total of 34 nodular lesions were found in 27 small hepatocellular carcinomas. The detection rates of plain scan, arterial phase, venous phase and arteriovenous phase were 70%, 91%, 79% and 94% respectively. According to the statistical analysis, the detection rate of both arterial phase and arteriovenous phase was more (P <0.05). There were no significant differences between the two groups during arterial phase and arteriovenous period (P> 0.05). The arterial phase of 65% (2 2/34) small hepatocellular carcinoma showed a uniform high density. CT value increased by 25.9 ± 14.4HU on average compared with the same period of liver tissue; 23% (8/34) showed an uneven high density . 79% of venous phase showed low density, compared with the same period of liver tissue, CT value decreased by an average of 18.7 ± 8.9HU; 2 1% (7/34) for the same density. The qualitative accuracy of double-phase scanning was 97% (31/32). Conclusion The double-helical CT scanning of venous and arterial phase has a high sensitivity and specificity for the diagnosis of small hepatocellular carcinoma.