杜忆兵 吴泽新 文明 王志兵 徐玉卡 马莲花 龙海彪 450065 郑州，解放军第一五三中心医院放射科 中华放射学杂志 1999 0 33 4


    关键词：肝肿瘤；肝硬化；体层摄影术，X线计算机 期刊 zhfsxzz 0 消化系统放射学 fur -->


    

【摘要】 目的 用螺旋CT双期扫描评价小肝癌，确定是否动脉期扫描比门脉期能改善对小肝癌的检测能力。方法 81例肝硬化并甲胎蛋白(AFP)阳性患者行双期扫描，共检出≤3cm肝癌39个。动脉、门脉期分别于注射造影剂后25秒、70秒开始扫描。比较小肝癌在两期内强化类型、 计算检出率及诊断正确率。结果 动脉期检出率为90%(35/39)。门脉期为67%(26/39)。74%小肝癌动脉期为均一高密度。门脉期定性正确率为58.9%，对≤1.0cm病灶为30.0%。联合动脉期后上述正确率明显增加，分别为87.1%和80.0%。结论 动脉期扫描能明显改善对小肝癌的检测能力， 两期结合能提高检出率及定性正确率。

Evaluation of dual-phase helical CT for detecting small HCC in patients with liver cirrhosis

DU Yibing, WU Zexin, WEN Ming, et al. Department of Radiology, the 153th Hospital of PLA, Zhengzhou 450065

【Abstract】 Objective To investigate on improving the diagnosis of small hepatocellular carcinoma (HCC) with dual-phase CT. Methods Dual-phase helical CT of the liver was done in 81 patients who had liver cirrhosis and high levels of α-fetoprotein, with scan delays of 25s (arterial phase)and 70s (portal venous phase). The enhancement pattern of each lesion on two phases was analysed, and the sensitivity and accuracy were also compared. Results Of the 39 small HCCs,35(90%) were detected on the arterial scan and 26 (67%) on portal venous phase. 74% of small HCCs showed homogeneous high attenuation in the arterial phase. The overall accuracy of diagnosis in portal venous phase was 58.9%, and 30.0% for lesions≤1.0cm in diameter. Combined the arterial with portal venous phase, the accuracy increased significantly to 87.1% and 80.0% respectively. Conclusions Arterial-phase helical CT of the liver could significantly improve detection of small HCCs. Combining the two phases, the sensitivity and accuracy of small lesions further improved considerably.

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