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目的探究不同浓度碘对比剂在64排多排螺旋CT(MDCT)中对高龄肝硬化肝癌患者的诊断价值与安全性。方法选取2014年1月至2015年12月收治的80例高龄肝硬化肝癌患者,采用随机数字表法将患者均分为A组和B组,每组40例,两组患者均行平扫和增强扫描,A组使用370 mg I/ml的优维显增强,B组使用300 mg I/ml的优维显增强,均注射100 ml,注射速度均为3.0 ml/s。测量两组患者增强肝实质、主动脉、门静脉的CT值,并统计两组患者病灶检出结果和两组患者不良反应发生情况。结果 A组患者增强后的肝实质CT值在门脉期、延迟期均明显高于B组(P均<0.05),A组主动脉CT值在动脉期明显高于B组(P<0.05),A组门静脉CT值在门脉期、延迟期均明显高于B组(P均<0.05);80例患者检出肝癌病灶236个,所有病灶动脉期和门脉期的诊断敏感性A组高于B组(P<0.05);两组患者的不良反应总发生率无统计学差异(P>0.05)。结论在高龄肝硬化肝癌患者的MDCT扫描中,高浓度对比剂在肝实质、主动脉、门静脉中能产生更高的CT值,且高浓度对比剂在动脉期和门脉期亦能提高肝癌的检出率,安全性与低浓度对比剂相似。
Objective To investigate the diagnostic value and safety of different concentrations of iodine contrast medium in 64 patients with multi-slice spiral CT (MDCT) for advanced liver cirrhosis. Methods Eighty elderly patients with liver cirrhosis who were admitted to our hospital from January 2014 to December 2015 were randomly divided into group A and group B with 40 patients in each group, Enhanced scanning, the use of 370 mg I / ml group A significantly enhanced the use of B, the use of 300 mg I / ml of the superior dimension significantly enhanced, were injected 100 ml, the injection rate was 3.0 ml / s. The CT values of liver parenchyma, aorta and portal vein were measured in two groups. The results of lesion detection in two groups and the incidence of adverse reactions in two groups were also calculated. Results The enhanced CT value of hepatic parenchyma in group A was significantly higher than that in group B in both portal and delayed phases (P <0.05). The CT value of aorta in group A was significantly higher in arterial phase than that in group B (P <0.05) , And the CT value of portal vein in group A was significantly higher than those in group B in both portal and delayed phases (P <0.05). A total of 236 liver cancer lesions were detected in 80 patients and the diagnostic sensitivity in all arterial and portal phases (P <0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P> 0.05). Conclusions In MDCT scan of patients with advanced cirrhosis and liver cancer, high contrast agent can produce higher CT value in liver parenchyma, aorta and portal vein, and high concentration of contrast agent can also improve liver cancer in arterial and portal venous phase Detection rate, safety and low concentrations of contrast agent similar.