二期与三期CT动态增强扫描对肝脏占位病变的诊断价值对比

目的：探讨二期（动脉期、门静脉期）CT增强扫描及三期（动脉期、门静脉期、延迟期）CT增强扫描对肝脏占位病变的诊断价值。方法选择本院收治的肝脏占位病变行手术治疗的35例患者，全部患者行三期CT动态增强扫描，由高年资医师对二期及三期CT图像进行评价，比较两者病变显示情况、血管显示及定性诊断结果，进而分析延迟期CT动态增强扫描的必要性及价值。结果二期及三期扫描在病灶、肝动脉、门静脉、肝静脉显示方面差异无统计学意义（P＞0．05），二期及三期扫描对肿瘤良恶性定性结果比较，差异有统计学意义（P＜0．05）；二期扫描诊断与病理符合率为65．7％，三期扫描诊断与病理符合率为94．3％，两组差异有统计学意义（P＜0．05）。结论与二期扫描比较，三期CT增强扫描并未明显增加病灶范围及相关血管显示率，但在一定程度上增加了肝脏肿块的定性价值，同时也增加了患者辐射剂量，临床应根据检查目的慎重选择。

Value of two and three phase dynamic enhanced CT scanning in diagnosis of liver lesions

Objective To investigate the diagnosis value of two phase （arterial,portal venous phase）CT enhanced scan and three phase （arterial,portal venous phase,delayed phase）CT enhanced scan in the diagnosis of liver lesions.Methods Clinical data of 35 cases given surgical treatment with liver lesions in our hospital were selected,and all patients underwent three phase dynamic enhanced CT scan. The two and three phase CT images were evaluated by experienced radiologists in order to compare the display situation of lesions,blood ves-sels and qualitative diagnosis,and then the necessity and value of delayed phase dynamic enhanced CT were analyzed.Results The lesions,hepatic artery,portal vein,hepatic vein display of two and three phase CT enhanced scan were compared,but the difference was not statistical-ly significant （P〉0.05）;the qualitative results of benign and malignant tumors detected by two methods were compared,and the difference was statistically significant （P〈0.05）.The consistent rate of two phase scan diagnosis and pathology was 65.7%,that of three phase scan was 94.3 %,and the difference was statistically significant （P〈0.05）.Conclusion Compared with two phase scan,three phase enhanced CT scan does not significantly increase the scope and display rate of the underlying vascular lesions,but it increases liver tumors qualitative value to a certain extent,and also increases the radiation dose of examination,so in clinic all these should be carefully weighed based on dif-ferent examination aims.