摘要
目的:研究多层螺旋CT多期增强扫描中肝血管瘤和肝细胞癌瘤周一过性异常血运灌注(THPE)的诊断价值。方法:所有病例均行多层螺旋CT多期扫描,其中46例肝血管瘤和32例肝细胞癌的肿块最大直径为5cm,分别发现71个肝血管瘤和47个肝癌结节。THPE表现为在动脉期肿瘤周围的肝实质出现楔形或不规则均匀强化,在门静脉期表现为等密度或略高密度。结果:肿块在3cm以下的肝血管瘤的THPE的发生率明显高于肝细胞癌(P<0.05);肿块在3～5cm的肝血管瘤的THPE的发生率与肝细胞癌差异无显著性意义(P>0.05)。肝血管瘤中THPE的发生率为23.94%,肝血管瘤的大小与THPE的发生无明显相关性,THPE常出现在快速强化的小血管瘤(58.82%)。结论:尽管缺少特异性,在<3cm快速强化的肿块中,血管瘤THPE的发生率要大于肝细胞癌,正确认识THPE能够对肿瘤的大小准确的评估并且为不典型肝小血管瘤和早期肝癌的鉴别提供佐证。
Objective：To study the value of transient hepatic peritumoral enhancement （THPE） in the diagnosis of hemangiomas and hepatocellular carcinomas during multi-phase enhanced multi-slice computed tomography （MSCT）. Methods：Multi-phase MSCT was performed on 46 cases of hemangiomas and 32 cases of hepatocellular carcinomas up to 5cm in diameter. THPE was diagnosed and comparatively analyzed when hepatic arterial phase CT scans showed a wedgeshaped or irregularly shaped homogeneous enhancement in the liver parenchyma adjacent to the tumor and when portal venous phase CT scans showed isoattenuation or slight hyperattenuation, compared with normal liver in that area. Results： For small lesions （〈3cm）,hemangiomas showed a higher incidence （P〈0.05） of THPE than hepatocellular carcinomas. For larger lesions （3-5cm）,there was no significant difference in the incidence of THPE between hemangiomas and hepatocellular carcinomas. T HPE was found in 17 （23.94%） of 71 hemangiomas. There was no statistically significant relationship between lesion size and presence of the THPE of hemangiomas （P〉0.05）. THPE was more frequently found in small hemangiomas with rapid enhancement （58.82%）. Conclusion：In spite of the limited specificity,for a 〈3cm small focal lesion with rapid enhancement THPE could suggest a higher possibility of hemangioma rather than hepatocellular carcinoma.
出处
《放射学实践》
2008年第6期625-627,共3页
Radiologic Practice
基金
黑龙江卫生厅资助项目(2006-149)
作者简介
赵德利（1975-），男，黑龙江桦南人，主治医师，硕士研究生，主要从事三维CT后处理及CT诊断工作。
