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目的 探讨肝细胞癌螺旋CT扫描CT征象在不同时相显示的最早时间和最丰富的时间 ,以便提出一个在时间窗上优化的扫描程序。材料与方法 41例确诊为肝细胞癌病例 ,应用SiemensSomatomPlus 4A螺旋CT设备 ,采用 10 0ml对比剂 ,3ml/s注射速度 ,于肿瘤靶平面进行动脉期 (延迟 14～ 2 1s)同层面动态扫描 ,然后行全肝门脉期 (延迟 80～ 85s)扫描和肿瘤靶平面平衡期 (延迟 170～ 2 85s)扫描。研究方法包括同行视 脑评价和数据检测评价。结果 肝细胞癌CT征象显示最早及最丰富时间平均为 18.62s和42 .2 6s。其峰值时间为 48.4s。结论 肝细胞癌CT征象显示最早及最丰富时间反映了肝细胞癌以动脉供血为主肝脏双重供血的特点。肝细胞癌肿瘤最大强化值应在包含肝动脉后期和门静脉早期的所谓混合期 ,而不在纯粹的肝动脉期。因此建议对可疑肝细胞癌的患者作同层面 (肿瘤靶平面 )增强动态扫描 ,其扫描时间可采用延迟 18、2 5、3 8和 45s ,然后作门静脉期全肝扫描 ,以便在一次性团注对比剂条件下获取较多的CT诊断信息。
Objective To investigate the earliest time and the most abundant time for CT signs of spiral CT scan in hepatocellular carcinoma, so as to present an optimized scanning procedure in time window. Materials and Methods Forty-one confirmed cases of hepatocellular carcinoma were treated with Siemens Somatom Plus 4A Spiral CT equipment, 100 ml contrast medium, 3 ml/s injection speed, and arterial phase (14-2 1 s delay) dynamic scan in the tumor target plane. Then the whole hepatic portal vein (delayed 80 ~ 85s) scan and the tumor target plane equilibrium phase (delay 170 ~ 2 85s) scan. Research methods include peer visual assessment and data detection and evaluation. Results CT signs of hepatocellular carcinoma showed the earliest and most abundant time averaged 18.62s and 42.26s. Its peak time is 48.4s. Conclusions The earliest and most abundant time for CT signs of hepatocellular carcinoma showed that hepatic cell carcinoma is characterized by arterial blood supply and hepatic dual blood supply. The maximum enhancement of hepatocellular carcinoma should include the so-called mixed phase of the hepatic artery and the early portal vein, not the pure hepatic artery phase. Therefore, it is recommended that patients with suspicious hepatocellular carcinoma should be given an enhanced dynamic scan at the same level (tumor target plane). The scan time can be delayed by 18, 25, 38, and 45 seconds, and then the portal venous phase scans the whole liver for a one-time use. In the condition of contrast agent, more CT diagnosis information was obtained.