双动脉期螺旋CT扫描在肝细胞癌诊断中的应用

目的比较双动脉（DAP）、门静脉三期与常规动、门双期CT增强扫描在肝细胞癌诊断中的应用。方法对60例临床实验室检查AFP均为阳性的患者，分别行常规动、门双期CT增强扫描及双动脉、门静脉三期CT增强扫描。常规动、门双期扫描方法以动脉期20～25s，门静脉期35～40s。双动脉、门静脉三期扫描方法以动脉早期（EAP）17～20s，动脉晚期（LAP）25～30s，门静脉期为35～40s扫描。分析两种扫描方法所得全部病灶的各期CT表现，评价两种检查方法对肝细胞癌（HCC），尤其是小肝癌病灶的检出率及准确性。结果常规双期扫描与双动脉、门脉三期扫描检查在HCC诊断的阳性检出率分别89．6％和97．7％，DAP检查小病灶准确性高于常规动、门双期，二组资料的差异具有统计学意义。结论双动脉、门静脉三期CT增强扫描对诊断肝细胞癌尤其是小肝癌有较高的临床应用价值。

Application of dual-arterial phase CT scan in diagnosis of hepatocellular carcinoma

Objective To compare the value of dual-arterial phase （DAP） combining portal phase as well as conventional arterial and portal phase enhanced CT scan in the diagnosis of hepatocellular carcinoma. Methods 60 cases with positive AFP were received conventional dual-phase enhanced CT scan and dual-arterial phase combing portal phase enhanced CT scan respectively. Conventional dual-phase included arterial phase （20-25s） and portal phase （35-40s）. Dual-arterial phase included early arterial phase （17-20s）, late arterial phase （25-30s） and portal phase （35-40s）. The detection rate and accuracy for hepatocellular carcinoma, especially for small liver carcinoma were analyzed. Results The positive diagnosis rate of HCC with conventional dual-phase method and DAP combining portal phase method was 89.6% and 97,7%, respectively. Diagnostic accuracy for small lesions was higher with DAP method than with the conventional dual-phase CT scan. Conclusion DAP combining portal phase enhanced CT scan is of higher clinical applied value in diagnosis of hepatocellular carcinoma, especially small liver carcinoma.