螺旋CT动态增强扫描在小肝癌诊断中的价值及临床意义

目的：探讨螺旋CT动态增强扫描在原发性小肝癌诊断中的价值及临床意义。方法：分析48例经临床及手术病理证实的原发性小肝癌的螺旋CT动态增强表现。结果：48例中共发现65个病灶,病灶位于肝左叶19个,右叶42个,尾状叶4个;病灶直径平均（2.56±0.31）cm。肝动脉期主要表现为高密度（93.8%）,门静脉期主要表现为低密度或稍低密度（72.3%）,延迟期主要表现为低密度（75.4%）,平扫呈低密度或等密度,病灶密度呈速升速降的变化特点。包膜完整的小肝癌患者PTEN表达阳性的比例显著高于无包膜或包膜不完整的小肝癌患者,两者间差异有统计学意义（P〈0.05）,经Spearman相关分析,PTEN蛋白的表达与肝癌完整包膜间呈正相关（r=0.215 2,P=0.024 1）。结论：螺旋CT薄层动态扫描可充分反映小肝癌的特征,对于提高小肝癌的检出率和定性诊断具有重要价值。

Clinical value of spiral CT dynamic enhanced scan in the diagnosis of small hepatocellular carcinoma

Objective： To investigate the clinical value of spiral CT dynamic enhanced scan in the diagnosis of small hepatocellular carcinoma. Methods： Forty-eight cases primary liver cancer which were confirmed by clinical and surgical pathology were chosen, they all underwent spiral CT dynamic contrast-enhanced scan. Results： there were 65 lesions in 48 patients, 19 lesions were located in the left lobe, 42 lesions in the right lobe, 4 lesions in the caudate lobe, the average diameter of the lesions（2.56 -＋ 0.31 ） cm. Hepatic arterial phase mainly for the high- density （93.8%） ; portal venous phase showed low density or slightly low density（72.3% ）, late period showed low density（75.4% ）, the scan showed low density or equidensity, lesion density was downhill speed up the change characteristics. Envelope full of small hepatocellular carcinoma in patients with positive PTEN expression was significantly higher than those without incomplete or capsular small liver cancer patients, there were significant differences between them （ P 〈 0.05 ）, by Spearman correlation analysis, PTEN protein expression was positive correlation with complete capsule with HCC （r =0. 215 2,P =0.024 1 ）. Conclusion： Thin spiral CT dynamic scanning can fully reflect the SHCC characteristics, it has great value for improving the detection and diagnosis of SHCC.