多层螺旋CT三期增强扫描对原发性肝癌的诊断及鉴别诊断价值

目的 探讨多层螺旋CT三期增强扫描对原发性肝癌的诊断及鉴别诊断价值.方法 随机选取2010年8月～2013年8月我院收治的肝部占位性病变患者72例进行回顾性分析,其中原发性肝癌患者32例,肝血管瘤患者18例,肝转移癌12例,肝内胆管细胞癌10例.结果 32例原发性肝癌患者动脉期强化病灶49个,门静脉期低密度病灶52个,延迟期24例密度低于临近的肝组织,8例呈等密度.12例肝转移癌患者动脉期及门静脉期均显示边缘连续环状强化,中央区供血少,可见“牛眼征”,延迟期呈低密度表现.18例肝血管瘤患者动脉期26个病灶结节状边缘,门静脉期病灶内增强范围增大,影像密度均匀及下降,延迟期几乎所有病灶均强化,密度接近于肝脏实质.10例肝内胆管细胞癌动脉期有5例出现病灶边缘环状强化斑,3例片状不均匀强化,2例不强化;门静脉期轻度不规则斑块样强化2例;延时期有4例不同程度向心性强化,密度稍高于正常的肝组织,网格样强化3例.结论 多层螺旋CT三期增强扫描对原发性肝癌的诊断及鉴别诊断提供可靠的依据,值得临床推广.

Three periods of multislice CT enhanced scan in the diagnosis of primary liver cancer and the differential diagnosis value

Objective To study the three periods of multislice CT enhanced scan in the diagnosis ot primary river cancer and the differential diagnosis value. Methods Selected randomly 72 cases of liver space-occupying lesions of the patients from August 2010 to August 2013 were analyzed retrospectively ,included 32 cases of primary liver cancer patients, 18 patients with hepatic hemangioma, 12 cases of liver metastatic carcinoma and 10 cases of intrahepatic bile duct carcinoma. Results 32 patients with primary liver cancer in arterial enhancement were 49,52 low density lesions was observed in portal venous phase delay in 24 cases of density was lower than the adjacent liver tissue ,8 cases of density,etc.12 cases of liver metastatic carcinoma patients with arterial and portal venous phase were all showed continuous circular edge reinforcement,central blood supply, ＂bull ＂s-eye＂ appearance,delay in low density.18 patients with hepatic hemangioma 26 lesions were appeared nodular arterial edge ,were increased the scope of the occurrence in portal venous phase lesions, and imaged density uniformity and fell, the delay almost afl lesions were strengthened, and the density was close to the liver parenchyma. In 10 patients with intrahepatic bile duct carcinoma,5 cases with arterial lesions edge ring reinforcement ,uneven spots, 3 cases with flake reinforcement, 2 cases with no reinforcement ;In portal venous phase mild irregular patches enhanced in 2 cases ; Delay period there were 4 cases with different degree of cen- tripetal reinforcement, density was slightly higher than the normal liver tissue,grid sample improved in 3 cases. Con- clusion The three periods of multislice CT enhanced scan on the diagnosis and differential diagnosis of primary hver cancer to provide reliable basis, was worthy of clinical promotion.