【摘要】 目的：评价三期动态增强ＣＴ对常见肝肿瘤诊断及鉴别诊断的价值，重点探讨动脉期扫描的意义。材料与方法：经手术病理或临床随访证实的常见肝脏肿瘤１１３例，其中肝细胞癌３８例，肝血管瘤４９例，肝转移瘤２６例。分别以２．５～３ｍｌ／秒的流速从前臂静脉注入６０％泛影葡胺１００ｍｌ后２０秒开始以动态程序扫描病变区。以兴趣区测量大血管、背景肝实质及肿瘤的强化ＣＴ值。观察动脉期（２６～３８秒），门静脉期（６４～７６秒）及平衡期（３００～３６０秒）肿瘤的强化特征，并对结果进行统计学处理。结果：（１）肝细胞癌的增强特征为：动脉期多表现为不同形式的高密度强化（占７１％），门静脉期及平衡期多表现为不同形式的低密度强化（分别占６８％及８１％）；（２）肝血管瘤大多三期均表现为不同形式的血管密度强化（分别占７１％、７８％及７３％）；（３）肝转移瘤的增强特征有二点：一是大多三期均表现为不同形式的低密度强化（分别占７７％、７３％及７７％），二是动脉期及门静脉期以不同密度的环形强化为主（占６２％）；（４）动脉期与门脉期强化密度的差异在肝细胞癌组有统计学意义，而在肝血管瘤及转移瘤组差异无显著性。结论：（１）三期ＣＴ对肝肿瘤的诊断及鉴别诊断有重要价值?更多还原

【Abstract】 Objective: To evaluate the diagnostic and differential value of triphasic, especially the arterial phase, dynamic enhanced CT scans for the liver neoplasm.Materials and Methods:Triphasic dynamic enhanced CT scan was performed in 113 patients with liver neoplasm proved pathologically or clinically, including hepatocellular carcinoma 38, hemangiomas 49, and metastatic tumor 26 cases. Hepatic arterial phase (HAP), portal vein phase (PVP) and delayed phase (DP) images were taken at 26～28, 64～76, and 300～360 seconds after injection of contrast, respectively. The CT attenuation of the neoplasm, hepatic parenchyma and blood vessel was measured on each image, and the data were analyzed statistically.Results:The characteristic findings of HCC were as follows: appearing hyper density on HAP (71%), hypo density on both PVP (68%) and DP (81%). (2)Most hemangiomas were iso density on HAP (71%), PVP (78%) and DP (73%). (3)Most metastatic tumors displayed hypo density, 77% on HAP, 73% on PVP and 77% on DP. Ring like enhancement was seen in 62% patients on HAP and PVP. (4)The difference in enhancement between HAP and PVP in HCC was statistically significant, while it was not significant in hemangiomas, nor in metastatic tumors.Conclusion: Triphasic dynamic enhanced CT scan is a valuable technique in detecting and differentiating hepatic neoplasm. HAP is helpful only to the HCC.更多还原