CT平扫与多期增强扫描对肝脏结节诊断价值探讨.docVIP

CT平扫与多期增强扫描对肝脏结节诊断价值探讨 　　摘要：目的探讨CT平扫与多期增强扫描对肝脏结节的诊断价值。方法选取经病理确诊的48例肝脏占位病变的患者为研究对象，对于多发性病灶在增强扫描显示清晰的情况下选取1~2个病灶为实验研究对象，本次研究共选取52个病灶为研究对象。分别对比平扫与增强扫描的诊断价值以及不同增强扫描方案的诊断价值。结果平扫共发现22例患者24个病灶，增强扫描共发现46例患者48个病灶。二者之间对比，有显著统计学意义（P＜0.05）。对于＜1.5cm的病灶，以动脉晚期+门脉晚期+延时期的检出率最高，对于≥1.5cm的病灶，不同方案之间无明显统计学意义。结论CT多期增强扫描能有效提高肝脏占位性病变的临床诊断率，能有效避免误诊的发生。 　　关键词：肝脏结节；计算机断层扫描；多期扫描；价值 　　CT Plain Scan and Enhancement Scanning in the Diagnosis of Hepatic Nodules 　　WU Jin,ZHOU Shun-ke 　　(The Second Affiliated Hospital of Central South University,Changsha 410003,Hunan,China) 　　Abstract：ObjectiveTo evaluate the value of CT multiple phase scan in diagnosis of hepatic nodules.MethodsForty-eight cases of hepatic nodules patients were enrolled in this study. We selected 52 lesions as subjects to evaluate the value of enhanced CT scan and different scanning project in diagnosis of hepatic nodules.Results There are 22 cases with 24 lesions found in CT unenhanced scan and 48 cases with 52 lesions found in CT enhanced scan. There is significant statistical difference between two groups(P＜0.05). To the lesion which is smaller than 1.5cm, the scanning project will be better if we choose the late arterial phase with the late portal venous phase. To the lesion which is bigger than 1.5cm, there is no significant statistical difference between different scanning projects.ConclusionCT multiple phase scan can effectively improve the accuracy in diagnosis of hepatic nodules. 　　Key words：Hepatic nodules; Computed tomography; Multiple scan; Value 　　正常肝脏具有双重血供特点，绝大多数肝脏结节主要是由肝动脉供血，因此注射对比剂后按照不同时相对肝脏进行扫描，可得到正常肝组织与肝脏结节不同的强化信息，从而对肝脏结节进行诊断[1-3]。本研究的目的在于对比CT平扫与增强扫描的诊断价值以及不同扫描方案的诊断价值。 　　1资料与方法 　　1.1一般资料选取经病理确诊的48例（肝癌28例，肝转移瘤20例）肝脏占位病变的患者为研究对象，包括男性32例，女性16例，患者年龄为22~78岁，平均年龄为（54.2±6.8）岁，病灶最大直径为1.5~13.8cm，平均直径为（4.5±1.2）cm，单发性病灶40例，多发性病灶8例；对于多发性病灶在增强扫描造影显示清晰的情况下选取1~2个病灶为实验研究对象，本次研究共选取52个病灶（肝癌32个，肝转移瘤20个）为研究对象。 　　1.2 CT检查参数及方法CT检查采用GE16多层螺旋CT扫描机，厚度为5~10mm。采用碘海醇作为对比剂，同时采用高压注射器注射，注射速度为3ml/s，注射20s后对患者行全肝区动脉期扫描，70s后行门脉期扫描，2min