螺旋CT三期增强扫描在肝血管瘤诊断中应用

目的：探讨螺旋CT三期增强扫描对肝血管瘤诊断的临床价值及应用方法。方法：搜集50例肝血管瘤患者行螺旋CT普通扫描后进行螺旋CT三期增强扫描的资料。扫描范围：全肝，层厚8mm，p=1．5；均采用高压注射器团注法单相期注射离子型或非离子型造影剂80—100ml(1．5—2．0ml／kg)，流率为2．5—3．5ml／s，扫描延迟时间为：肝动脉期：20—30S；门静脉期：60—70S；延迟扫描分两步走，第一次延迟时间为3—5min第二次延迟时间为：10—15min。结果：螺旋CT普通扫描：表现为肝内边界较清楚的低密度病灶。增强扫描：病灶大于1cm的44例，其中大于5cm的12例，均可见典型的肝血管瘤的CT表现。其中15例为多发，而其中5例是在倒置期中检出小于1cm的多发病灶。单发小于1cm者6例，虽无明显肝动脉期结节样强化，但具有门静脉期和延迟期的典型改变。结论：肝血管瘤在三期增强各期中大多数有典型表现，根据肝血管瘤的强化特点将期强化过程分为四期，即边缘结节强化期、向内部充填期、密度倒置期、等密度期。根据增强各个时期病灶的动态变化特点即可定性诊断，而且在显示病灶全貌尤其对倒置期的显示，大大提高了三期增强扫描对小肝血管瘤的检出率以及与肝癌的鉴剐能力。

Application of 3-phase contrast-enhanced spiral CT in diagnosing hemangioma of liver

Objective:To in vestigate the clinical value and methods of 3-phase enhance spiral CT scanning in diagnosing hemangioma of liver.Methods:50 cases of hemangioma of liver scanned by 3-phase contrast-enhanced spiral CT after common scan. scan region: whole liver, thickness 8 mm, p=1.5; all used high pressure united injection single phase to inject type contrast media or no ion type contrast 80-100ml(1.5-2.0mlkg) and injected rate 2.5-3.5 mls.Results:spiral common CT scan: with low density and smooth margin in liver, 9 cases with small and more low density satellite lesions in or surround the hemangioma of liver. enhanced CT: 44 cases the diseases are more than 1 cm and 12 of them are more than 5 cm. All have typical CT exhibition, among of them 15 cases with many diseases, five of them were found many little diseases less than 1 cm in the phase of delay. 6 cases less than 1 cm is single without typical enhancement, but have other typical exhibition in phase of portal vein and delay.Conclusion:majority hemangiomas hve typical exhibition and base on character of hemangioma enhance to separate it for 4 phase, liver artery-phase (A-phase), portal vein-phase(P-phase),delay-phase(D-phase).P-phase and D-phase are important in finding small diseases and improve the ability to compare with primary liver cancer.