螺旋CT多期扫描在肝小血管瘤与小肝癌诊断的临床应用

目的：探讨小肝细胞癌和肝脏小血管瘤螺旋CT增强表现及其随时间延迟所致的CT征象的变化过程，材料与方法：50例患者（15例SHCC，35例SHHE），其中19例经手术病理标本证实，其余患者由临床表现和实验室检查诊断，采用Siemens Plus4C螺旋CT机，先作平扫，然后在肿瘤靶平面平衡期扫描。着重观察，分析不同CT扫描时相小肝细胞癌和肝脏小血管瘤CT表现特征的动态变化过程，结果，SHHE组发现病灶44个，30个病灶在动脉期动缘明显强化逐渐向中心填充，22个病灶在动脉期和门静脉期均为高密度，2个病灶在动脉期和门静脉期均为底密度，在平衡期42个病灶SHHE为高密度和等密度SHCC组发现二18个，14个病灶SHCC显示动脉期呈高密度、门静脉期为低密度，3个病灶动脉期为高密度、门静脉期为等密度、1个病灶动脉期、门静脉期均为低密度，平衡期16个病灶的SHCC为低密度，结论：根据SHHE和SHCC在螺旋CT多期扫描的强化表现，大多数病例可明显两者诊断。

Clinical Application of More-phase Spiral CT in Small Hepatocellular Carcinoma and Small Hepatic Hemangioma

Objective: To investigate the enhanced spiral CT features of SHCC and SHHE,and the changing of these features with time. Materials and Methods: Of 50 cases with SHCC(15/50)and SHHE (35/50), 19 cases were surgically and pathologically proved, and the others were clinically diagnosed. Plain scanning, single-level dynamic scanning of the target section during hepatic arterial phase (delaying 25-30 sec.), portal venous phase scanning(delaying 60-70 sec.)of the whole liver, and equilibrium scanning of the target section here performed. The dynamic changes of CT features were observed and analyzed. Results: 35 cases with SHHE were found in 44 focuses. Peripheral enhancement significantly of the lesion were found 30(30/44) focuses on the arterial phase scan and to fill up by degrees from the periphery of the lesion to center. Hemogenous enhancement was seen in 22(22/44) focuses and 2(2/44) focuses did not showed enhance-ment on the arterial phase and the portal venous phase scan. 42(42/44)cases with SHHE showed high or equal density compare with the liver density on the equilibrate phase scan. 15 cases with SHCC were found in 18 focus . Hemogenous enhancement was seen in 14 (14/18) focuses on the arterial phase scan and did not showed enhance-ment on the portal venous phase scan. 2(2/18) cases with SHHE showed hemogenous or no hemogenous enhancement on the equilibrate phase scan. 16(16/18) cases with SHCC showed low density compare with the liver density on the equilibrate phase scan. Conclusion: According to the enhanced spiral CT features and the changing of these features with time, the most of SHCC and SHHE were diagnosed.