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目的:探讨螺旋CT动态增强扫描在原发性小肝癌诊断中的价值及临床意义。方法:分析48例经临床及手术病理证实的原发性小肝癌的螺旋CT动态增强表现。结果:48例中共发现65个病灶,病灶位于肝左叶19个,右叶42个,尾状叶4个;病灶直径平均(2.56±0.31)cm。肝动脉期主要表现为高密度(93.8%),门静脉期主要表现为低密度或稍低密度(72.3%),延迟期主要表现为低密度(75.4%),平扫呈低密度或等密度,病灶密度呈速升速降的变化特点。包膜完整的小肝癌患者PTEN表达阳性的比例显著高于无包膜或包膜不完整的小肝癌患者,两者间差异有统计学意义(P<0.05),经Spearman相关分析,PTEN蛋白的表达与肝癌完整包膜间呈正相关(r=0.215 2,P=0.024 1)。结论:螺旋CT薄层动态扫描可充分反映小肝癌的特征,对于提高小肝癌的检出率和定性诊断具有重要价值。
Objective: To investigate the value of spiral CT dynamic contrast-enhanced scanning in the diagnosis of primary small hepatocellular carcinoma and its clinical significance. Methods: Forty-eight cases of primary small hepatocellular carcinoma confirmed by clinical and operative pathology were analyzed by dynamic spiral CT. Results: Totally 65 lesions were found in 48 cases. There were 19 lesions in the left lobe, 42 lesions in the right lobe and 4 in the caudate lobe. The average diameter of lesions was (2.56 ± 0.31) cm. The hepatic arterial phase mainly showed high density (93.8%), portal venous phase mainly showed low density or slightly lower density (72.3%), delayed phase mainly showed low density (75.4%), flat or low density, The density of the lesions showed the characteristics of rapid change and rapid decrease. The positive rate of PTEN expression in patients with intact small hepatocellular carcinoma was significantly higher than that in patients with small hepatocellular carcinoma without or with incomplete capsule (P <0.05). Spearman correlation analysis showed that PTEN protein There was a positive correlation between the expression and complete capsule of HCC (r = 0.215 2, P = 0.024 1). Conclusion: The spiral CT thin-layer dynamic scanning can fully reflect the characteristics of small hepatocellular carcinoma and is of great value in improving the detection rate and qualitative diagnosis of small hepatocellular carcinoma.