肝血管瘤与肝癌非延迟CT扫描的鉴别诊断

Distinction between Hepatic Cavernous Hemangioma and Hepatocellular Carcinoma on Enhanced CT without Delayed Images

关键词:  断层摄影术  X-线计算机  肝血管瘤  肝癌

Key words:  tomography  x-ray computed  hepatic cavernous hemangioma  hepatocellular carcinoma

摘要:

分析肝血管瘤与肝癌在一过性非延迟增强扫描时的CT增强表现,并寻找它们的特点。对经穿刺活检及手术病理检查证实的31例肝肿瘤病人的CT资料(肝血管瘤16例、肝癌15例)作回顾性分析。所有病人均行平扫后立即做传统团注增强扫描,描述:病灶增强的类型;病灶强化的程度;强化组织的分布。造影剂用量为1.5mL/kg体重。结果,81%的肝血管瘤及8%的肝癌病灶可见到球状或结节状强化,(P<0.05)。81%的肝血管瘤病灶呈等或高于同层主动脉密度改变,而所有的肝癌病灶侧未见到此种改变;(P<0.01)。81%的肝血管瘤和43%的肝癌增强结节呈周边分布,(P<0.05)。13%的肝血管瘤和61%的肝癌病灶呈弥漫不均匀强化,统计学分析差异有显著性。表明,病灶周边结节状或小球样增强灶,其密度与同层主动脉密度一致是在一过性非延迟增强扫描中,诊断肝血管瘤的一个可靠征象;而病灶线状或弥漫不均匀强化则是肝癌的较可靠的依据。

Abstract:

To analyse contrast-enhanced CT appearance without delayed images for differentiating hepatic cavernous hemangioma (HCH) and hepatocellular carcinoma (HCC),CT manifestations of 31 patients with HCH (16 patients) and HCC (15 patients) were retrospectively evaluated. CT examinations were pre formed with no-delayed scan following bolus injection of 1.5mL/kg of contrast material. All lesions were evaluated based on the following criteria:type of enhancement, degree of enhancement,distribution of enhancement.81% of HCH had globular enhancement compared to 7% of HCC (P<0.05). 81% of HCH had enhancement isodense with the aorta and all the HCC lesions had not this signs (P<0.01). 81% of HCH and 43% of HCC had globular and peripheral enhancement (P<0.05).13% of HCH and 53% of HCC had diffuse and heterogedeous enhancement (P<0.05). The lesion with globular and peripheral enhancement that is hypo-or isodense with the aorta is highly characteristic of HCH on no-delayed images,but the lesion with linear, diffuse and heterogeneous is most appearances of HCC.