肝动脉和经动脉门脉造影螺旋CT联合应用对肝癌的诊断价值

目的　探讨螺旋CT扫描在肝动脉造影CT(CTHA)和经动脉门脉造影CT(CTAP)对肝癌的诊断价值。方法　分析 2 1例肝癌病人CTAP和CTHA图像 ,并与螺旋CT三期增强扫描进行对照。结果　三期增强扫描病灶检出率为 72 .4% (5 5 /76) ;CTAP病灶检出率为 96.1% (73 /76) ;CTHA病灶检出率为 88.2 % (67/76) ;CTAP和CTHA联合应用病灶检出率为 98.7% (75 /76) ,可检出 0 .5cm的微小癌灶。CTAP和CTHA均可出现非病理性表现 ,CTAP灌注异常出现率为 2 2 .3 % ,CTHA非病理性强化灶出现率为 3 0 .2 %。结论　螺旋CT动脉造影能显著减少造影剂用量 ,提高图像质量 ,CTAP和CTHA联合应用肝癌病灶检出率明显高于CT三期增强扫描。CTAP和CTHA结合分析可减少假阳性率。

The Diagnostic Value of Spiral CT ( CT Arterial Portography and CT Hepatic Arteriography) for Hepatic Carcinoma

Objective To evaluate the diagnostic value of spiral CT [CT arterial portography (CTAP) and CT hepatic arteriography(CTHA)] for hepatic carcinoma. Methods The CTAP and CTHA manifestations in 21 patients with hepatocelluar carcinoma were analyzed and compared with those in three-phase enhanced CT . Results The detection rate of three-phase enhanced CT was 72.4% , CTAP and CTHA was 96.1% and 88.2% respectively. The detection rate of combination CTAP and CTHA was 98.7% . They could reveal tumors of 0.5 cm in diameter . Both CTAP and CTHA gave false-positive findings , such as perfusion defects in 22.3% of CTAP and non-pathologic enhancement in 30.2% of CTHA .Conclusion With the use of spiral CT technique , the quantity of contrast material administrated in CTAP and CTHA can be considerably reduced . And the quality of CT images significantly improved . The detection rate of CTAP and CTHA is higher than that of three-phase enhanced CT . Simultaneous use of both procedures may decrease the false-positive rate.