肝细胞癌门静脉侵犯的多层螺旋CT动态增强研究

目的探讨肝细胞癌（HCC）门静脉侵犯的形成机制、多层螺旋CT（MSCT）动态增强表现及临床意义。方法对316例HCC患者进行肝脏MSCT动态增强检查，共发现88例门静脉侵犯，其MSCT征象结合DSA表现综合分析。结果88例HCC门静脉侵犯患者在MSCT动态增强扫描时均显示了相关的阳性征象。88例中，门静脉癌栓（TTPV）72例，其中36例合并门静脉海绵状变性（CTPV）；肝动脉-门静脉分流（APS）60例；同时伴有TTPV和APS42例；肝脏血流灌注异常16例。结论MSCT为HCC门静脉侵犯的诊断提供了一种重要的检查工具。对研究HCC门静脉侵犯的发生机制及肝癌的治疗都具有重要的指导意义。

Study on Dynamic Enhanced Multislice Spiral CT: Hepatocellular Carcinoma with Portal Vein Invasion

Objective To evaluate the formative mechanisms and the dynamic enhanced multi-slice spiral CT(MSCT) features and their clinical significance of hepatocellular carcinoma(HCC)with portal vein invasion(PCI).Methods Three hundred and sixteen patients with HCC were received dynamic enhanced MSCT scan of the liver,of which eighty-eight patients with PCI were found and the MSCT signs were analyzed with DSA findings.Results All the 88 patients with PCI had related positive CT signs in dynamic enhanced scan.The results were as follows: 72 cases of tumor thrombus of the portal vein(TTPV),36 cases of cavernous transformation of portal vein(CTPV) among the 72 cases TTPV,60 cases of arterioportal shunt(APS),16 cases of abnormal perfusion of hepatic blood flow. Conclusion MSCT provides an important examining tool for the diagnosis of HCC with PCI,and is of important significance in the study on the formative mechanisms and the treatment of HCC with PCI.