【摘要】 目的 探讨螺旋CT肝脏双期扫描及门静脉血管三维重建在小肝癌诊断中临床应用价值。方法 25例直径≤3cm小肝癌行螺旋CT肝脏双期扫描及门静脉血管三维重建。三维重建方法采用最大强度投影(MIP)。结果 (1)CT平扫,18例病灶呈低密度,7例病灶呈等密度。肝动脉期,25例病灶强化呈高密度,强化类型分为均匀一致性,斑点状及环状强化。门静脉期25例病灶均呈低密度。(2)门静脉血管MIP三维重建能较好显示小肝癌病灶与肝内门静脉血管关系,肝内门静脉血管分支于病灶处稀少,部分中断或被轻度推移,肿瘤内无门静脉分支血管。结论 螺旋CT肝脏双期扫描及门静脉血管三维重建是诊断和评价小肝癌的有效方法,提高了小肝癌的检出率及诊断正确率,可较好显示病灶与门静脉的关系,为其外科手术提供导向。更多还原

【Abstract】 Purpose To assess the diagnostic and clinical application value of hepatic helical dual - phase CT scanning and 3D CT of portal venous system in small hepatocellular carcinoma. Methods small hepatocellular carcinomas( ≤3cm)were examined by hepatic helical dual - phase CT scanning,MIP reconstruction were used as three- dimensional models. Results lesions were hypodensity and 7 lesions were equal density in CT scans without contrast. 25 lesions were hyperdensity in hepatic helical artery phase, including three enhancement types: homogenous, spot and circular. All lesions were hypodensity in portal vein phase.MIP could demonstrate the relationship between lesions and intrahepatic portal vein,and distal portal vein was deviated or displaced. Conclusion Hepatic helical dual phase CT scanning and 3DCT of portal Venous system are effective methods in diagnosing and evaluating small hepatocellular carcinoma, and can improve the detection and characterization of small hepatocellular carcinoma, and help surgeon to plan the treatment.更多还原