螺旋CT动脉门脉造影在小肝癌诊断中的价值

目的：用螺旋ＣＴ动脉门脉造影（ＳＣＴＡＰ）评价肝癌并与超声（ＵＳ）及螺旋ＣＴ双期扫描进行检出敏感性和定性准确性比较研究。方法：肝癌４１例，行ＳＣＴＡＰ后分析病灶灌注特征，统计各种方法病灶检出数，计算检出敏感性及定性准确性并行统计学处理。结果：４１例共检出≤３ｃｍ病灶４５个，ＳＣＴＡＰ检出敏感性为９５．５％，双期扫描肝动脉期、门静脉期及双期合计的检出敏感性分别为：８８．８％、６８．８％、９１．１％，ＳＣＴＡＰ与ＵＳ（６６．６％）和双期扫描门脉期相比有显著性差异（ｐ＜０．０１）。其定性准确性为（９５．３％），明显高于ＵＳ（８０．０％）。结论：ＳＣＴＡＰ能可靠反映小肝癌、肝实质血流灌注特征，明显提高病灶检出敏感性及定性准确性。螺旋ＣＴ动脉造影（ＳＣＴＡ）显示病变动脉血管最佳，两者结合可增加诊断特异性。

The Evaluation of spiral CT Arterial Portography in the Diagnosis of Small HCC

Objective:To evaluate HCC by spiral CT during arterial portography(SCTAP)and to compare the sensitivity and accuracy of detection of HCC with US and dual-phase CT.Methods:SCTAP of the liver in 41 patients with HCC was done with a helical CT scanner.The perfusion abnormality of the lesions was analysed,the sensitivity in detecting lesions and the accuracy of characterization of each method were statistically calculated.Results:The study showed that the sensitivity in detecting small lesions on SCTAP was 95.5% and on arterial,portal and dual-phases were 88.8%,68.8% and 91.1% respectively.The significant difference was found among SCTAP,US(66.6%) and portal venous phase.The accuracy of characterization of SCTAP (95.3%) was superior to US(80.0%).Conclusion:SCTAP can reliably reflect the perfusion characteristics of small HCC and liver parenchyma,improve the sensitivity in detection and accuracy of lesions.Spiral CT arteriography(SCTA) is very useful in showing the arterial supply of HCC.Combining SCTAP with SCTA can raise the specificity in the diagnosis of hepatic tumors.