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目的 评价螺旋CT三期增强扫描对肝细胞腺瘤的诊断及鉴别诊断的价值 ,重点探讨动脉期扫描的意义 ,以进一步提高CT诊断的准确性。方法 5例肝腺瘤均行平扫及三期增强扫描 ,10 0ml对比剂 ,3ml/s单相注射 ,延迟 2 0～ 30s行动脉期扫描 ,6 0～ 70s行门脉期扫描 ,3min后行延迟期扫描。测量腺瘤及正常肝组织的强化CT值 ,观察腺瘤的三期强化特征 ,并对结果进行统计学分析。结果 5例肝腺瘤平扫表现为等密度或略低密度 ,与正常肝组织无法区分 ;动脉期均表现为高密度 ,其平均CT值与正常肝组织相差 38HU ,定量比较有显著性差异 (t=18 94,P <0 0 1) ;在门脉及延迟期 ,4例腺瘤表现为等密度 ,1例为略低密度 ,分别与正常肝组织平均CT值相差 (3 7± 7 1)HU和(- 4 3± 3 6 )HU ,定量比较差异无显著性意义 (t =1 10 ,t=0 75 ;P值均 >0 0 5 ) ;肝腺瘤动脉期平均CT值明显高于门脉及延迟期 ,定量比较有显著性差异 (F =18 39,P <0 0 1)。结论 螺旋CT三期增强扫描对肝腺瘤的诊断与鉴别诊断有重要价值 ,尤其是动脉期扫描。
Objective To evaluate the value of three-phase enhanced helical CT in the diagnosis and differential diagnosis of hepatocellular adenomas, focusing on the significance of the arterial phase scan in order to further improve the accuracy of CT diagnosis. Methods Five cases of hepatic adenoma underwent plain scan and three-phase enhanced scan, 100ml contrast medium, 3ml/s single-phase injection, delayed 20 to 30s arterial phase scan, and 60~70s portal scan, 3min later. Line delay scan. The enhanced CT values of adenoma and normal liver tissue were measured to observe the enhancement characteristics of adenoma at the third phase, and the results were statistically analyzed. Results The plain scans of 5 patients with hepatic adenomas showed equal density or slightly low density, which was indistinguishable from that of normal liver tissues. The arterial phase showed high density. The mean CT value was different from that of normal liver tissues by 38 HU. There was a significant difference in quantitative comparison ( t = 18 94, P <0 0 1); In the portal vein and delayed phase, the adenoma showed isodensity in 4 cases and slightly low density in 1 case, which was different from the mean CT value of normal liver tissue (3 7 ± 7 1). ) HU and (- 4 3 ± 3 6) HU, quantitative comparison showed no significant difference (t =1 10, t=0 75; P values were> 0 05); hepatic adenoma showed significantly higher average CT value during arterial phase In portal vein and delayed period, there was a significant difference in quantitative comparison (F = 18 39, P <0 01). Conclusion The three-phase enhanced helical CT scan has important value in the diagnosis and differential diagnosis of hepatic adenoma, especially the arterial phase scan.