原发性肝细胞癌的多层CT血管造影表现及临床应用价值

目的探讨原发性肝细胞癌的多层螺旋双期CT血管造影表现及后处理技术.方法所有42例于MX8000 4层螺旋CT机上进行增强扫描,有效层厚3.2 mm,重建间隔1.6 mm,对比剂用量1.5 ml/kg体重,注射速率3 ml/s,延迟时间分别为25 s、50～55 s.进行最大密度投影(MIP)、多平面重组(MPR)、容积再现(VR)处理.结果动脉期显示肿瘤染色者18例,肿瘤血管23例.12例进行了DSA检查,MSCT所显示的肿瘤染色、肿瘤血管及供血动脉的来源与分布与DSA检查一致.门静脉期,检出门静脉瘤栓12例,门静脉闭塞14例,动-静脉分流8例.MIP、MPR及VR有利于检出肝癌的肿瘤染色、肿瘤血管、供血动脉、门静脉闭塞及动-静脉分流.结论 MSCT肝脏双期血管造影可以提供有关肝癌本身、供血动脉及门静脉改变的信息.

Multislice CT angiographic appearances of hepatocellular carcinoma and its clinical applications

Objective To discuss biphase multislice computed tomography (MSCT) angiographic appearances of hepatocellular carcinoma (HCC) and post-processing techniques. Methods Forty-two cases of HCC were scanned using a MX8000 four-slice CT scanner with slice thickness of 3.2 mm, overlapping interval of 1.6 mm, and the volume of delivered contrast agent is 1.5 ml/kg body weight, injection rate of 3 ml/s, delay time was 25 s, 50-55 s, respectively. Maximum intensity projection (MIP), multiple planar reconstruction (MPR), and volume rendering (VR) were made. Results In the arterial phase, tumor stain were seen in 18 cases, tumor vascularity in 23 cases. MSCTA of the arterial phase had a high consistency with DSA in 12 cases for tumor and supplying arteries. In the portal venous phase, portal thrombosis were seen in 12 cases, portal occlusion in 14 cases, 8 APSs. MIP, MPR, and VR could detect tumor stain, tumor vascularity, supplying arteries, portal occlusion and APS. Conclusion Biphase MSCT angiography can provide diagnostic information about HCC, supplying arteries and portal venous changes.