摘要
目的 检验多层螺旋CT薄层增强 3期扫描 (triple phasehelicalCT ,THCT)在小肝癌(SHCC)诊断中的作用。方法 研究分析 10 0例SHCC患者的CT图像。采用高质量扫描模式 ,扫描参数为 :层厚 5mm ,螺距 3 ;增强 3期扫描 (以下简称 3期扫描 )分别为平扫、注射对比剂后 2 0～ 2 5s动脉期扫描、45～ 5 0s门静脉期扫描、3min延迟期扫描 ,12 0kV ,2 70～ 3 0 0mA。高压注射器单相注射 ,非离子型对比剂注射流率为 3ml/s (剂量为 1 2～ 1 5ml/kg)。通过放射科影像存储与传输系统 (PACS)的医学图像浏览及诊断报告书写终端分析SHCC的CT图像 ,确定肿瘤强化特点。分析SHCC强化特点与其组织学分类和分级间的关系。统计学分析CMHχ2 检验和Fisher确切概率法检验。结果 SHCC在 3期扫描上 81例为典型表现 ,即动脉期为高密度、门静脉期和延迟期为低密度或等密度 ;19例为非典型表现。SHCC 3期扫描检出率统计学上差异有非常显著意义 (χ2 值为 2 11 95 3 ,P =0 0 0 1) ,以延迟期检出率最高。SHCC中以梁型较多 ,与其他分类比较 ,统计学上差异有非常显著意义 (Fisher确切概率法 ,P =0 0 0 60 4)。SHCC在病理组织分级上差异无显著意义 (χ2 值为 2 13 3 ,P =0 144 )。结论 大多数的SHCC在 3期扫描上呈典型表现。SHCC定性诊断?
Objective To study the role of multi-slice helical CT (MSCT) triple-phase images in the detection of small hepatocellular carcinoma (SHCC). Methods One hundred SHCC patients were detected by triple-phase spiral CT (THCT) with 5-mm-thick-section, among them, 74 cases were diagnosed by operations and 24 cases by transcathether arterial chemoembolization (TACE). Nonenhanced scans were obtained in all cases, along with hepatic arterial-phase (HAP), portal venous-phase (PVP), and delayed-phase (DP) images at 20-25 seconds, 45-50 seconds, and 2-3 minutes, respectively, after intravenous 1.5 ml/kg nonionic contrast material injection at a rate of 3 ml/s. The characterization of SHCC were studied by three radiologists with network imaging workstations of picture archiving and communication system (PACS) with software of RadworksTM 5.1. The correlation between the CT features and pathological changes in SHCC was studied. Results The sensitivity for all SHCC was as follows: HAP, 94%; PVP, 88%; and DP, 96% in THCT. The CT characterizations were iso- and hypodense in unenhanced CT scan, hyper- and isodense in HAP, hyper-, iso- and hypodense in PVP, iso- and hypodense in DP. There were significant differences in THCT (χ 2=211.953,P=0.001) and in histopathology typing (P=0.006 04). Eight-one case of SHCC expressed typical findings and 19 cases had non-typical findings on CT scan. Conclusion Most cases of SHCC have typical findings in CT enhanced scan. Detection of SHCC was well achieved in arterial-phase and delayed-phase scan, especially delayed-phase scan. Thin section THCT scan possesses an important significance in detection of SHCC. Complex triple-phase imaging characterizations can improve the diagnosis and differential diagnosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2002年第11期1028-1031,共4页
Chinese Journal of Radiology
关键词
多层螺旋CT
薄层增强
诊断
小肝癌
Carcinoma, hepatocellular
Tomography, X-ray computed
