螺旋CT双期扫描对小肝癌的诊断价值

目的评价螺旋CT扫描的动脉期、静脉期以及双期联合应用对小肝癌的诊断价值。方法对27例小肝癌行螺旋CT双期增强扫描，增强动脉期于造影剂注射后25～30s开始扫描，静脉期于65～70s开始扫描，造影剂注射速率为2.5～3.0ml/s，用量70～85ml。结果27例小肝癌共发现34个结节病灶。平扫、动脉期、静脉期、动静脉双期的检出率分别为70%、91%、79%、94%，经统计学分析，动脉期和动静脉双期的检出率较平扫和静脉期高（Ρ＜0.05），动脉期和动静脉双期间、平扫和静脉期间比较均无统计学意义（Ρ＞0.05）。65%（22/34）的小肝癌动脉期呈均匀高密度，与同期肝组织比较，CT值平均增加25.9±14.4HU；23%（8/34）呈不均匀高密度。79%静脉期呈低密度，与同期肝组织比较，CT值平均减少18.7±8.9HU；21%（7/34）为等密度。双期扫描的定性准确率为97%（31/32）。结论螺旋CT动、静脉双期扫描对小肝癌诊断有很高的敏感性和特异性。

Evaluation of Dual-phase Spiral CT in Diagnosis of Small Hepatic Cell Carcinoma

Objective To evaluate the diagnostic value of dual-phase spiralCT in diagnosis of small hepatic cell carcinoma(SHCC).Methods Dual-phase spiral CT was performed in 27 patients with SHCC(≤3 cm).The scans began at 25-30 s arterial phase and at 65～70 s in portal venous phase after intravascular atministration.The injection rate of contrast media was 2.5 ml/s with a total of 70～85 ml. Results 34 lesions were found in 27 patients.The detecting rate of lesions on non-contrast scanning,arterial phase,portal venous phase and dual phase were 70%,91%,79%,94% respectively.The sensitivity of arterial and dual phase were higher than that of non-contrast scanning(NC)and portal venous phase(Ρ＜0.05).There was no significant difference found between NC and portal venous phase(Ρ＞0.05),arterial phase and dual phase(Ρ＞0.05) 65% of SHCC lesions showed homogeneous high attenuation with the enhancement of 25.9±14.4 HU compared with the liver tissue on the arterial phase,and 23% of SHCC showed unhomogeneous high attenuation,79% of lesions on portal venous phase showed lower density than that of liver tissue on the same phase with the decreasing of 18.7±8.9 HU,21% of lesions showed the same density.The accurate rate of diagnosis of dual-phase was 97%.Conclusion Dual-phase spiral CT of liver is of high sensitivity and specificity in diagnosis of SHCC.