肝癌动门脉分流动态增强CT和DSA对照分析

目的:探讨肝癌动门脉分流(APS)的CT和DSA表现,评价CT和DSA诊断不同类型APS的价值。方法:回顾性分析27例肝癌APS患者的动态增强CT和DSA资料。将APS分为中央型、周围型和弥漫型,分析3种类型APS的3期动态增强CT和DSA表现。结果:APS的基本影像学表现是在动脉期门静脉系统提前强化和相应供血区的肝组织明显强化。27例中CT共检出APS39个,其中中央型11个、周围型18个、弥漫型10个;DSA检出APS51个,其中中央型11个、周围型30个、弥漫型10个。在周围型APS诊断上,CT不及DSA(P<0.05),但两者均存在不足。结论:APS具有特征性的CT和DSA表现。CT和DSA可以准确地评价中央型和弥漫型APS,但评价周围型APS时存在不足。

Arterio-portal Shunts in Hepatoma: a Correlative Study of Dynamic Enhancement CT and DSA

Objective:To investigate the CT and DSA features of arterio-portal shunts (APS) related to hepatoma and to evaluate the diagnostic value of CT and DSA in different types of APS.Methods:Twenty seven cases with APS related to hepatoma were studied using dynamic enhanced CT and DSA.APS was divided into three types,i.e.central type,peripheral type and diffuse type.CT and DSA findings of APS of these three types were analyzed retrospectively.The value of CT and DSA in the diagnosis of APS was evaluated.Results:The basic feature of APS is early enhancement of portal venous system and the marked enhancement of liver parenchyma supplied by the shunt during hepatic arterial predominant phase.Of the 27 patients,thirty nine APS were depicted by CT;there were central APS (n=11),peripheral APS (n=18) and ten diffuse APS (n=10).Fifty one APS were showed on DSA,there were central APS (n=11),peripheral APS (n=30) and diffuse APS (n=10).For the diagnosis of peripheral APS,CT was inferior to DSA (P<0.05).Disadvantages of both CT and DSA were existed.Conclusion:APS had characteristic dynamic enhanced CT and DSA features.Central APS and diffuse APS could be accurately evaluated by dynamic enhanced CT or DSA,but for the diagnosis of peripheral APS,a few pitfalls were existed in both modalities.