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目的分析肝转移瘤(HMs)螺旋CT多期扫描表现,探讨适合HMs诊断、鉴别诊断及检出的螺旋CT最佳扫描计划。方法收集原发灶明确、并经临床、CT证实的HM46例,所有病例均作了螺旋CT平扫和动脉期、门脉期、平衡期增强扫描,5例尚作了延迟扫描。至少两位医师阅片,分析记录HMs螺旋CT多期表现。结果平扫多数瘤灶(69.6%)呈外周略低密度中央更低密度。多期增强扫描,第1类少血供37例(80.4%),以门脉期明显环形强化为主;第二类富血供6例(13.0%),以动脉期明显环形强化为主;第三类无血供3例(6.6%),动脉期、门脉期、平衡期均无强化。结论对有特征性的少血供或无血供HMs仅需门脉期单期扫描;而对富血供者,则需作多期扫描,以便与其它富血供的肝脏病变鉴别。
Objective To analyze the multislice spiral CT scans of liver metastases (HMs) and explore the best spiral CT scan plan for diagnosis, differential diagnosis and detection of HMs. Methods We collected HM46 cases with definite primary tumor and confirmed by clinical and CT. CT scan and arterial phase, portal phase, and balance phase were all performed in all cases. Delay scanning was performed in 5 cases. At least two physicians read the film and analyzed the multiphase performance of spiral CT of HMs. Results The majority of tumors (69.6%) showed a slightly lower central density at the lower part of the circumference. Multi-phase contrast-enhanced scanning was performed in 37 cases (80.4%) with less blood supply in category 1, with a significant annular enhancement in the portal venous phase. Six cases (13.0% The third type of no blood supply in 3 cases (6.6%), arterial phase, portal phase, balance were no strengthening. Conclusions Only portal venous phase single-phase scanning is required for characteristic hypofunction or non-hemotopoietic HMs, while multi-phase scanning is required for hemifacial donor in order to differentiate it from other hemopoietic liver diseases.