16层螺旋CT双动脉期对小肝癌的诊断价值.docVIP

16层螺旋CT双动脉期扫描对小肝癌的诊断价值 王文献，文利，刘卫金，梁开运，邹利光（第三军医大学新桥医院放射科，重庆 400037） （本教研室原创，wjl上传） 摘要：目的 评价多排螺旋CT（multidetector row helical CT, MDCT）双动脉期扫描对小肝癌的诊断价值 方法 回顾性分析经临床和病例证实的22例、共26个病灶的小肝癌临床和影像学资料；扫描采用美国GE lightspeed plus 16层螺旋ＣＴ进行检查，增强扫描采用3～4期(动脉早期和晚期、门脉期、平衡期或延迟期)，动脉早期为20ｓ，动脉晚期为30ｓ，,门脉期：55～65ｓ，平衡期：100～120ｓ，延迟期为5分钟，每个全肝扫描周期为8.2s；扫描结束后；在工作站对图像进行处理，选定病灶、正常肝组织区为兴趣区（region of interest ，ROI），对同一ROI分别在不同的时相上测量、对比和计算。结果 病灶位于肝左叶10例，肝右叶16例。26个病灶单纯动脉早期呈高密度者7个，平均CT值为62.3±14.6HU，检出率为26.9%；单纯动脉晚期呈高密度者18个，平均CT值为87.9±16.6HU，检出率为69.2%；双动脉期显示高密度的病灶25个，检出率为96.2%；门脉期显示低密度病灶19个，检出率达73.1%。26个病灶中在动脉早期表现为高密度，门脉期为低密度的病灶数有7个，检出率为26.9%。在动脉晚期表现为高密度，门脉期为低密度的病灶数有17个，平均CT值为56.2±13.6HU，检出率为65.4%，门脉期显示高密度病灶4个，平均CT值为82.9±17.8HU，检出率为15.4％。结论 MDCT双动脉期扫描，能较大的提高小肝癌的检出率。 　　关键词：肝肿瘤；体层摄影术，X线计算机 作者简介：王文献（1951－），男，河南禹洲市人，硕士，教授，主要从事影像学诊断和研究， 发表论文30余篇，电话：（023E－mail：wxw745866@ Small hepatocellular carcinoma: detection with double arterial phase multi-slice helical CT WANG Wen-xian, WEN Li, LIU Wei-jin, LIANG Kai-yun, ZOU Li-guang(Radiology Department, XinQiao Hosp, TMMU, Chongqing, 400037) Abstract: objective To explore the value of multidetector row helical CT (MDCT）in diagnosing small hepatocellular carcinoma. Methods Twenty-two cases of small hepatocellular carcinoma (26 lesions) verified by clinic and pathology were analyzed retrospectively. Using GE lightspeed plus 16 CT, enhancement scaned with three to four phases: early artery phase (delay 20 s), late artery phase (delay 30 s), portal vein phases (delay 55~65 s), equilibrium phase (delay 100~120 s), and delay phase (delay 5 min). The whole liver scaned in 8.2 s. Post processed the images at workstation, including selecting lesion and normal liver as regions of interest (ROIs), and measuring, comparing, and calculating the same ROI at different phases. Results Ten lesions located in left lobule, 16 in right lobule. Of all the 26 lesions, 7 appeared as high density at early artery phase, (mean CT value 62.3±14.6HU, detective ratio 26.9%), 18 ap