320排CT多时相动态容积增强扫描对原发性肝癌的强化特征研究

摘要

目的 探讨320排CT多时相动态容积增强扫描对原发性肝癌的诊断价值.方法 对40例肝癌患者进行320排CT多时相动态容积增强扫描(TOSHIBA 320排CT-Aquilion One).根据原始数据计算机绘制肝动脉、肝癌及周围肝实质的时间-密度曲线(TDC),记录肿瘤强化峰值时间和肿瘤持续强化时间,分析全肝动脉期瘤灶强化特征.结果 320排CT多时相动态容积增强扫描共检出瘤灶40个,肿瘤强化峰值时间为22～36 s,均值为29 s；肿瘤持续强化的时间平均为14 s.320排CT多时相动态容积增强扫描发现并诊断肝内异常灌注灶31个.异常灌注灶开始强化时间平均为22 s,持续强化时间平均为12s,恢复为等密度的时间平均为34 s.异常灌注灶多呈点状、斑片状、长条状或楔形.结论 320排CT低剂量多时相动态容积增强扫描能够量化肿瘤强化峰值时间和肿瘤持续强化时间,实时动态记录肿瘤强化的过程和特点,可对肝癌的诊断及鉴别诊断提供重要的影像信息.%Objective To investigate the diagnostic value of 320-row CT multi-phase dynamic volumetric contrast scan for hepatocellular carcinoma (HCC).Methods 40 HCC patients were investigated using a 320-row CT multi-phase dynamic volumetric contrast scan (Aquilion One; Toshiba Medical,Otawara,Japan).The time density curves (TDC) of hepatic artery,hepatocelluar carcinoma and liver parenchyma could be delineated on the basis of the initial data.The time to peak enhancement and the total time of duration enhancement of the 40 HCCs were recorded.The enhancement of tumor in the whole arterial phase was analyzed.Results 40 HCCs were detected by the 320-row CT multiphase dynamic volumetric contrast scan.The mean time to peak enhancement of 40 HCCs was 29(22-36)s.The mean time of durative enhancement was 14s.31 hepatic perfusion disorders (HPD) were detected by the 320-row CT multi-phase dynamic volumetric contrast scan,showing dot,patchy,strip and wedge.The mean time to enhancement was 22 s.The mean time of durative enhancement was 12s.The mean time of restoring to isodensity was 34s.Conclusions 320-row CT multi-phase dynamic volumetric contrast scan with a low dose of contrast agent could result in real-time capture of accurate information for the time to peak enhancement and the total time of duration enhancement of tumor,thus overally reflected the feature and mechanism of tumor enhancement,and provided important image information for diagnosis and differential diagnosis of HCC.