原发性肝癌多层面CT双动脉期与门静脉期增强扫描分析

目的：探讨原发性肝癌多层面CT（multi-slices CT,MSCT）双动脉期与门静脉期增强扫描各期强化特征及癌灶的检出率。方法：104例原发性肝癌治疗前行MSCT的平扫与三期扫描（双动脉期与门静脉期扫描）,对比剂用量100 ml,以3 ml/s的速率肘静脉注射,采集时间动脉早期20～22 s,动脉晚期34～37 s,门静脉期60 s。测病灶平扫及各增强期CT值,分析病灶的强化情况及检出情况,以增强各期检出的肿瘤数目为肿瘤灶总数。结果：三期增强扫描共显示470个病灶,34个均匀强化;436个不均匀强化,〈3 cm病灶动脉早期检出117个（56.25%）,动脉晚期检出171个（82.21%）,门静脉期检出137个（65.86%）,≥3 cm的病灶动脉早期检出237个（90.45%）,动脉晚期检出250个（95.41%）,门静脉期检出244个（93.12%）。56个仅在三期增强扫描的一期显示,动脉早期5个,动脉晚期25个,门静脉期26个。结论：动脉晚期的检出率明显高于门静脉期与动脉早期。双动脉期与门静脉期增强扫描有利于提高肝癌检出效率。

Multi-slices CT with double arterial phase and portal venous phase in detection of primary liver cancer

Objective: To describe CT findings of primary liver cancer in double arterial phase and portal venous phase of multi-slices CT(MSCT) and evaluate their effect on detection of cancer lesions.Methods: One hundred and four patients with primary liver cancer were examined by abdominal plain CT and MSCT scanning at 20-22s(early arterial phase,EAP),35-37s(late arterial phase,LAP) and 60s(portal venous phase,PVP).The CT density in hounsfield units of liver cancer were measured in every phase,and lesion detection and CT appearance were analyzed.Results: In three enhanced phase,470 lesions were detected,of which 34 lesions demonstrated homogenous enhancement and 436 lesions inhomogenous enhanced.Detection rates were 56.25%,82.21%,and 65.86% respectively in EAP,LAP and PVP for lesions less than 3 cm,and 90.45%,95.41% and 93.12% respectively for lesions equal to or more than 3 cm.56 lesions were seen only in one of contrast-enhanced imaging phase,including 5 lesions at EAP,25 at LAP and 26 at PVP.Conclusion: The detection rate of LAP is higher than that of LAP and PVP.Tri-phase MSCT can improve detection and visualization of liver cancer.