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目的:通过分析非典型肝癌的CT图像,探讨CT误漏诊原因,提高非典型肝癌的CT诊断率。方法顾性分析68例经病理、DSA或随诊观察确诊的肝癌患者的图像,采用高质量扫描模式,扫描参数为层厚5cm～7cm,螺距为1,造影剂注射扫描速率为3ml/s,均行3期增强扫描,即动脉期(25s～30S),门脉期(50s～60s),延迟期(3min～10min),观察病灶在不同时期的特征。结果68例患者中典型病例42例,约占61.8%。非典型病例26例。约占38.2%.其中误诊8例,漏诊4例,随诊观察6例,穿刺活检3例,DSA确诊5例。结论:非典型肝癌在肝脏的三期扫描中约占38.2%左右,合理选择扫描参数,结合临床综合分析,随诊观察,DSA检查,活检等可以避免或减少误诊及漏诊。
OBJECTIVE: To analyze the causes of CT misdiagnosis and to improve the CT diagnosis rate of atypical liver cancer by analyzing the CT images of atypical liver cancer. Methods Sixty-six patients with hepatocellular carcinoma diagnosed by pathology, DSA or follow-up were analyzed with high-quality scanning mode. The scanning parameters were slice thickness of 5cm-7cm, pitch of 1, contrast agent injection scanning rate of 3ml / All the patients underwent three-stage enhanced scanning, that is, arterial phase (25s-30s), portal phase (50s-60s), and delayed phase (3min-10min). Results Of the 68 patients, 42 were typical cases, accounting for 61.8%. Atypical cases in 26 cases. Accounting for 38.2%, of which 8 were misdiagnosed, 4 were missed, 6 were followed up, 3 were biopsy, and 5 were confirmed by DSA. Conclusion: Atypical liver cancer accounts for about 38.2% of the three stages of liver scanning. Reasonable selection of scanning parameters, combined with clinical analysis, follow-up observation, DSA examination and biopsy can avoid or reduce misdiagnosis and missed diagnosis.