螺旋CT多期扫描在肝门胆管癌术前评估中的价值

目的　探讨螺旋CT多期扫描在肝门胆管癌术前评估中的价值。方法　经病理证实的26例肝门胆管癌行常规上腹部平扫和增强扫描。增强扫描在注入造影剂后30s、70s时分别行动脉期和门脉期扫描。另有15例加做了3~4min的延迟期扫描。肝门区采用3~5mm的薄层扫描。观察肿块的部位、大小、强化的特征和累及的范围。评价手术可切除性。结果　多期相扫描能发现所有病灶。动脉期16个病灶有强化。门脉期26个病灶均有强化,其中19个病灶明显强化。15个做延迟期扫描的病灶均有持续强化。可切除性评估的准确性为84. 62%。结论　螺旋CT多期增强扫描结合薄层扫描技术可清晰显示病灶的部位和强化特征,明显提高了肝门胆管癌的可切除性估价的准确性,有助于术前治疗方案的选择和预后的估计。

The Value of Helical CT Multi - phase Contrast Scanning in the Preoperative Evaluation of Hepatic Portal Cholangiocarcinoma

Objective To study the value of helical multi-phase contrast scanning in the preoperative evaluation of cholangiocarcinoma hilar.Methods Pre-and post-contrast CT scanning of upper abdomen were performed in 26 cases with hepatic portal cholangiocarcinoma.Arterial phase scan of the whole liver began at 30 s after initial injection of contrast medium and the portal venous phase scan started at 70 s.15 of 26 cases underwent additional delayed phase scans began at 3~4 min.Thin thickness(3~5 mm)scanning of hepatic portal was used in each post-contrast phase scanning.The location,size,enhancement patterns of the lesions and the extent of the tumor involvement were observed and surgical resecetability was evaluated.Results All of 26 lesions were detected in helical multi-phase contrast scanning. 16 lesions enhanced on the arterial phase. On the portal venous phase, all lesions were enhanced and marked enhancement was seen in 19 lesions. Prolonged enhancement was seen in 15 lesions on the delayed phase scanning. The accuracy of evaluating surgical respectability was 84.62%. Conclusion Multi-phase contrast scanning combined with thin thickness scanning can demonstrate obviously the location and enhanced patterns of hepatic portal cholangiocarcinoma, the accuracy in evaluating surgical respectability is improved, and it is helpful in choosing the preoperative treatment program and assessing the prognosis.