| 128 层螺旋 CT 三期动态增强在鉴别高分化肝癌和局灶性结节增生中的价值 |
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| 引用本文： | 张春,;王敏君,;曾献军,;张静坤,;罗强,;余晨,;况红妹. 128 层螺旋 CT 三期动态增强在鉴别高分化肝癌和局灶性结节增生中的价值[J]. 矿产勘查, 2014, 0(5): 46-49 |
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| 作者姓名： | 张春, 王敏君, 曾献军, 张静坤, 罗强, 余晨, 况红妹 |
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| 作者单位： | [1]南昌大学研究生院医学部2011级,南昌330006; [2]南昌大学第一附属医院影像科,南昌330006; [3]南昌大学研究生院医学部2012级,南昌330006 |
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| 摘 要： | 目的：探讨128层螺旋CT三期动态增强在鉴别高分化肝癌（WHCC）和局灶性结节增生（FNH）中的诊断价值。方法分析41例肝脏占位病变患者（其中20例 WHCC为 WHCC组、21例 FNH 为 FNH 组）128层螺旋CT三期动态增强扫描图像，观察有无假包膜、有无肝硬化、有无肿块纤维瘢痕；测量病灶大小、病灶平扫 CT值、平扫值与正常肝脏的 CT比值、动态增强的峰值、动态峰值与肝脏比值、动脉期 CT值（AP 值）、静脉期 CT 值（VP值）、延时期CT值（DP值）。结果假包膜：WHCC组12例，FNH组0例；中央纤维瘢痕：WHCC组0例，FNH组8例；肝硬化：WHCC组7例，FNH组1例。WHCC组年龄大于 FNH 组[（58．40±0．29）岁比（41．20±0．46）岁， P＜0．01]。WHCC组较 FNH 组的平扫 CT值（42．90±1．76比51．33±1．26）、动态增强峰值（94．74±4．49比116．74±4．25）、峰值与肝脏比值（1．30±0．72比1．63±0．59，）、AP值（74．10±4．15比102．71±4．10）、VP 值（84．05±4．62比107．05±3．76）、DP值（78．70±2．99比95．24±3．35）显著降低（均P＜0．01）。结论假包膜为WHCC固有特征，中央纤维瘢痕为 FNH 常见特征。三期动态增强扫描年龄、平扫 CT 值、动态增强的峰值、AP值、VP值、DP值对 WHCC和 FNH的检出和鉴别诊断有一定价值。
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| 关 键 词： | 高分化肝癌 局灶性结节增生 三期动态增强 体层摄影术,X线计算机 诊断,鉴别 |
Value of Three-Phase Dynamic Contrast-Enhanced 1 28-Slice Spiral CT in Differential Diagnosis of Well-Differentiated Hepatocellular Carcinoma and Focal Nodular Hyperplasia |
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| Affiliation: | ZHANG Chun, WANG Min-jun, ZENG Xian-jun, ZHANG Jing-kun, LUO Qiang, YU Chen, KUANG Hong-mei (a. 2011 Grade of Medical Department of Graduate School b. Department of Radiology of the First Affiliated Hospital e. 2012 Grade of Medical Department of Graduate School, Nanchang University, Nanchang 330006, China) |
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| Abstract: | Objective To explore the value of three-phase dynamic contrast-enhanced 128-slice spiral CT in the differential diagnosis of well-differentiated hepatocellular carcinoma（WHCC）and focal nodular hyperplasia（FNH）.Methods Three-phase dynamic contrast-enhanced 128-slice spi-ral CT was performed in 20 patients with WHCC（WHCC group）and 21 patients with FNH （FNH group）.The pseudocapsule,cirrhosis and fibrous scar were observed.In addition,lesion size,nonenhanced CT value,average CT value,average lesion-to-normal liver CT ratio,dynamic contrast-enhanced peak value,dynamic peak-to-liver ratio,arterial phase CT value（AP value）,ve-nous phase CT value（VP value）and delay period CT value（DP value）were measured.Results In WHCC group,pseudocapsule,central fibrous scar and cirrhosis were observed in 12,0 and 7 pa-tients,respectively.In FNH group,pseudocapsule,central fibrous scar and cirrhosis were observed in 0,8 and 1 patients,respectively.Compared with FNH group,age,nonenhanced CT value,dy-namic contrast-enhanced peak value,dynamic peak-to-liver ratio,AP value,VP value and DP value significantly decreased in WHCC group[（58.40±0.29）years vs （41.20±0.46）years,42.90± 1.76 vs 51.33±1.26,94.74±4.49 vs 116.74±4.25,1.30±0.72 vs 1.63±0.59,74.10±4.15 vs 102.71±4.10,84.05±4.62 vs 107.05±3.76 and 78.70±2.99 vs 95.24±3.35,respectively;P〈0.01].Conclusion The pseudocapsules and central fibrous scar are the inherent features of WH-CC and FNH,respectively.Three-phase dynamic contrast-enhanced 128-slice spiral CT is valuable for the detection and differential diagnosis of WHCC and FNH. |
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| Keywords: | well-differentiated hepatocellular carcinoma focal nodular hyperplasia three-phase dynamic contrast-enhanced tomography,X-ray computed diagnosis,differential |
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