螺旋CT双期扫描诊断伴肝硬化的小肝癌的探讨

目的：探讨螺旋CT双期增强扫描诊断伴肝硬化的小肝癌的价值。方法：14例伴肝硬化的小肝癌患手术及病理发现小肝癌病灶21个（直径≤3cm)，回顾性分析螺旋CT双期增强扫描的结果，比较小肝癌在动脉期和门脉期内强化类型，检出率及诊断正确率，结果：动脉期检出率为85．7％（18／21），门脉期有71．4％（15／21），66．7％小肝癌动脉期为均一高密度，门脉期定性正确率为52．4％，联合动脉期和静脉期后，其检出率和定性正确率分别增加至90．5％和80．9％。结论：动脉期扫描明显增加小肝癌的检出，两期结合能提高检出率及定性正确率。

Evaluation of Dual-phase Spiral CT for Detecting Small HCC in Patients with Liver Cirrhosis

Objective To evaluate the value of dual phase spiral CT for the diagnosis of small hepathocellular carcinoma(HCC) accompanied with liver cirrhosis. Methods 21 small HCCs were verified through operation and pathology in 14 cirrhotic patients with small hapatocellular carcinoma. The results of dual phase spiral CT were analyzed retrospectively, including the enhancement pattern of each lesion on two phases, the sensitivity and accuracy.Results Of the 21 small HCCs,18(85.7%) were detected on the arterial phase and 15(71.4%)on portal venous phase. 66.7% of small HCCs showed homogeneous high enhancement in the arterial phase. The overall accuracy of diagnosis in portal venous phase was 52.4%. Combined the arterial with portal venous phase, the sensitivity and accuracy increased significantly to 90.5% and 80.9% respectively.Conclusion Arterial phase spiral CT of the liver can significantly improve detection of small HCCs. Combining the two phases, the sensitivity and accuracy of small lesions further improves considerably.