摘要
目的:分析总结硬化型肝癌的螺旋CT多期扫描表现,以进一步提高对该病的诊断准确性。材料和方法:经手术证实的7例硬化型肝癌患者行螺旋CT平扫和多期增强扫描。注射造影剂后30s开始动脉期扫描,70s开始门脉期扫描,另有4例加做3～4min的延迟期扫描,观察病灶的强化方式。结果:平扫7个病灶均为低密度。动脉期6个病灶有轻度的不规则环形、点状或结节状强化,1例无强化。门脉期7个病灶均有不同程度的强化,如不规则环形强化、边缘结节状强化或中心强化等,强化范围较动脉期增大。延迟期4个病灶仍有各种各样的强化表现。结论:硬化型肝癌的螺旋CT多期扫描表现特殊,以早期轻度强化、门脉期和(或)延迟期仍有持续强化为主,需认真与血管瘤及炎性假瘤鉴别,了解其CT表现有助于临床正确诊断和治疗方案的选择。
Purpose: To analyze and summarize the manifestations of sclerosing hepatocellular carcinomas on the multi-phase contrast scans of spiral CT and improve the diagnostic accuracy. Materials and Methods: Spiral CT scanning of pre-and post-contrast was performed in seven cases proved by surgery. Arterial phase scan of the whole liver began at 30s after initial injection of contrast medium and the portal venous phase scan started at 70s. Four of seven cases underwent additional delayed phase scans begun at 3～4 min. The enhancement patterns of the lesions were observed. Results: All of seven lesions appeared as hypodense on pre-contrast CT scans. On the arterial phase, six lesions enhanced slightly, showed as irregular circular, punctual or nodular enhancement, the other one lesion showed no enhancement. On the portal venous phase, all of seven lesions had various enhancements, such as irregular circular, peripheral nodular or central enhancement. The coverage of the enhancemeut was larger than that on the arterial venous phase. Various prolonged enhancements were seen in 4 lesions on the delayed phase scan. Conclusion: The manifestations of sclerosing hepatocellular carcinoma on the multi-phase contrast scans of spiral CT are special, mainly showed as slightly enhancement on the arterial phase scan and had prolonged enhancement on the portal venous phase and/or delayed phase scan, which should be seriously differentiated from hemangioma or inflammatory pseudotumor. Understanding the enhancement patterns of sclerosing hepatocellular carcinoma on the multi-phase contrast scan of spiral CT is helpful to make a right clinical diagnosis and choose the treatment programs.
出处
《中国医学计算机成像杂志》
CSCD
2003年第6期417-420,共4页
Chinese Computed Medical Imaging
