螺旋CT动态增强扫描对肝细胞癌合并门静脉癌栓的诊断价值(附32例分析)

目的探讨肝细胞癌合并门静脉癌栓发生机制和螺旋CT动态增强扫描的表现。方法32例肝细胞癌门静脉癌栓形成的患者作螺旋CT平扫和增强扫描,10例进行了多平面重组(MPR)成像,9例患者治疗后作CT随访。结果螺旋CT轴位和MPR图像能清晰显示门静脉癌栓,直接的CT征象为门静脉增粗及充盈缺损,门脉血管软组织肿块影和门静脉癌栓内及周围可见网状供血动脉。间接征象主要有侧支循环形成及周围肝脏动力学的改变。螺旋CT扫描可以评价门静脉癌栓治疗后的变化情况。结论螺旋CT动态增强扫描轴位图像结合MPR可以完整地提供门静脉癌栓的影像资料,对肝细胞癌患者治疗方法的选择及预后判断具有重要价值。

Diagnostic value of helical CT dynamic contrast enhancement scan for hepatocellular carcinoma associated with portal tumor thrombus(An analysis of 32 eases)

Objective To study the pathogenic meehanism of hepatocellular carcinoma associated with portal tumro thrombus and the manifestation of helical CT dymamic contrast enhaneement scan.Methods From January 2004 to October 2005,169 cases with hepatocellular carcinoma received examination of helical CT dynamic contrast enhancement scan.Among them,32 cases with portal fumor thrombus were found and one was anulyzed eom,prehensively.Results The imaging manifestation of 32 cases with hepatocellular carcinoma associated with portal tumorthrombus were enlarged portal vein and dilatation,intraluminal filling defect of portal vein and cylindric or dendritic tumor thrombus.Conelusion Helical CT cancorrectly judge the position of hepatoeellular carcinoma associated with portal tumor thrombus,extent of tumor thrombus and it's relationship between the peripheral tissues or structures,If has an important significance for the treatment of hepatocellular carcinoma.