多排螺旋CT双期增强扫描对巨块型肝癌诊断价值.docVIP

多排螺旋CT双期增强扫描对巨块型肝癌诊断价值【中图分类号】R735.7；R814.42 【文献标识码】A【文章编号】1003-8183-（2011)09-0009-02【摘要】目的：探讨原发性肝癌的多排螺旋CT双期增强特征及其诊断价值。方法：回顾性分析58例经临床及手术病理证实的巨块型肝癌双期增强表现，分析有关的CT征象。结果：①肿瘤实质均呈不均匀性强化，并可出现3种基本形态的肿瘤血管，它们与瘤内“密度更低区”有一定的关系；②部分肿瘤边缘部或包膜分别或同时在动脉期及门脉期出现环形强化；③87.1%的巨块型肝细胞癌肝内转移性子灶只在动脉期才被检出。结论：①巨块型肝细胞癌螺旋CT双期增强扫描的强化特点及动脉期瘤内出现肿瘤血管，不但是巨块型肝细胞癌的主要特征，而且具有重要的鉴别诊断价值；②部分巨块型肝细胞癌边缘部或包膜存在肝动脉、门脉或动、门脉双重血供；③巨块型肝细胞癌术前必须进行全肝范围的动脉期增强扫描，以利于发现占大多数平扫及门脉期均呈等密度的肝内转移性子灶 【关键词】肝肿瘤；巨块型肝癌；螺旋CT；诊断 Multi-slice Spiral CT Dual-phase Enhanced Scanning of Huge Blocks of Diagnostic Value of Hepatocellular Carcinoma Zhang Hua， Zhou Liqing， Liang Zhaoyu 【Abstract】Objective：To investigate the primary liver cancer multi-slice spiral CT dual-phase enhanced characteristics and diagnostic value. Methods ：Retrospective analysis of 58 cases confirmed by clinical and surgical pathology of giant hepatocellular carcinoma dual-phase enhanced performance， analysis of the CT signs. Results ：① real Juncheng tumor heterogeneity strengthened， and may appear three kinds of basic patterns of tumor blood vessels， and along with tumors of quot；low-density areasquot； have a certain relationship； ② part of the department or the edge of tumor capsule， either separately or simultaneously in arterial period and appeared ring-enhanced portal venous phase； ③ 87.1% of the huge blocks of hepatocellular carcinoma lesions patience intrahepatic metastasis was only detected only in the arterial phase. Conclusions ：① massive type of hepatocellular carcinoma enhanced dual-phase helical CT scan of the enhanced features and arterial aneurysms occur within tumor blood vessels， is not only a huge block of the main features of hepatocellular carcinoma， but also has an important differential diagnosis； ② part of the huge block of Department of hepatocellular carcinoma， or coated edge exists hepatic artery and portal vein， or move， the dual blood supply of portal； ③ massive type of hepatocellular carcinoma before surgery wide range of hepatic arter