双螺旋CT增强三期薄层扫描在小肝癌诊断中的价值

目的：探讨双螺旋CT增强三期薄层扫描在小肝癌诊断中的价值。方法：分析100例中采用双螺旋CT增强三期薄层扫描(triple-phase duplex-helical CT，TDHCT)检出的76个(瘤径≤3cm)小肝癌(small hepatocellulat carcinoma，SHCC)的CT图像，由有经验的CT室医师通过医学影像工作站(MIW)和医学影像存储与传输系统(PACS)的医学图像浏览终端，分析、统计SHCC各时相病灶强化类型，计算检出率。依SHCC的典型表现，即动脉期高密度、门静脉期和延迟期为等或低密度，做出诊断。结果：76个SHCC在三期扫描中，动脉期、门静脉期和延迟期检出率分别为86．8％(66／76)、61.8％(47／76)、93．4％(71／76)。小肝癌在动脉期89．3％(59／66)呈高密度，在门静脉期87．2％(41／47)呈低密度，在延迟期100％(71／71)呈低密度。结论：SHCC定性诊断主要依靠其自身形态强化特点，双螺旋CT增强三期薄层扫描能提高SHCC的检出率，TDHCT可提高SHCC诊断和鉴别诊断水平。

The value of triple-phase duplex-helical CT in the diagnosis of small hepatocellular carcinoma

Objective:To evaluate the value of triple-phase duplex-helical CT(TDHCT) in the diagnosis of small hepatocellular carcinoma(SHCC).Methods:100 patients were taken triple-phase duplex-helical CT and 76 CT images of SHCC checked.Then the images were analyzed by the seconed CT physician through the MIW and PACS and the SHCC diagnosed according to the typical expression in different phase in artery.Results:The diagnostic rate of SHCC in artery,portal vein and delayed phase of TDHCT was 86.8%(66/76),61.8%(47/76) and 93.4%(71/76) respectively.77.6% SHCC presented high density in artery phase,54% low density in portal vein phase and 93% low density in delayed phase.Conclusion:Most cases of SHCC have typical findings in CT enhanced scan.Detection of SHCC was well achieved in arterial-phase and delayed-phase scan,especially delayed-phase scan.Thin section TDHCT scan possess an inportant significance in detection of SHCC.TDHCT imaging charaterizations can improve the diagnosis and differential diagnosis.