【摘要】 目的:探寻常见肝脏肿瘤动态增强CT的最佳扫描间期(GSI)。材料与方法:经手术病理或临床随访证实的肝细胞癌38例,血管瘤49例,转移瘤26例。以2.5-3ml/秒的注射速度从前臂静脉注入60％泛影葡胺90ml后20秒开始以动态程序扫描病变。以兴趣区测量肿瘤及背景肝实质的CT值。 结果:1.肝血管瘤的增强峰值最高,肝癌Ⅰ型次之,肝癌Ⅱ型及肝转移瘤较低;肝癌Ⅰ型增强达峰值时间早于肝癌Ⅱ型,肝转移瘤最迟。各组间差异有显著性(P<0.05)。2.肝癌Ⅰ型病变与背景肝实质较大增强密度差的时期(PNHIDI)分为两段:30-47秒及63秒至平衡期起点,肝癌Ⅱ为53秒至平衡期起点,肝血管瘤及肝转移瘤分别为26秒及51秒至平衡期起点。结论:肝癌I型的OSI为团注后30—47秒及76—108秒,肝血管瘤及肝转移瘤分别为26—75秒及57—106秒,与其PNHIDI一致,肝癌Ⅱ型的OSI为40-89秒,较其PLHIDI稍提前,以便显示反映病灶特征性血供和灌注情况的增强征象。更多还原

【Abstract】 Objective: To determine the optimal scanning intervals (OSI) for different liver neoplasmes. Materials and Methods: Triphasic dynamic enhanced CT was performed in 113 patients with liver neoplasm proved pathologically or clinically, including 38 cases of hepatoceliuiar carcinoma (HCC), 49 cases of hemangiomas and 26 cases of metastatic tumor. Each patient’ s dynamic CT scans were performed at 20-sec following the administration of 60% urografin 90ml with a rate of 2.5 - 3ml/s from a perphery vein. Neoplasms and liver parenchymal enhancement were measured on each scan. Results: 1.The peak enhancements of hemangiomas and Type One HCC were significantly higher than that of other two teams. The time from commencement of injection to the peack enhancement of Type One HCC were significantly earily than that of Type Two HCC. And that of metastatic tumor were the most delayed one. 2. The intervals of relatively higher difference in blood iodine concetration between focal neoplasm and liver parenchymal (PNHIDI) of Type one HCC were divided into two phases: 30 - 47 seconds and 63 - sec to onset of equlibrium phase (EPO). That of Type Two HCC were from 53 - sec to EPO. PNHIDI of hemangima and metastatic tumor were 26 - 75 seconds and 57 - 106 seconds, which were in accordance with their PNHIDI. But that of TypeTwo HCC were 40 - 89 seconds, a little earlier than their PNHIDI in order to include the phase which could show the characteristic tissue perfusion patterns.更多还原