【作者】 王静；

【导师】 刘文亚； 温浩；

【作者基本信息】 新疆医科大学 ， 医学影像， 2006， 硕士

【摘要】 目的 分析肝癌多层螺旋CT血管成像的表现，探讨其临床应用价值。方法 83例经手术病理及临床确诊的肝癌患者行多层螺旋CT检查，经图像处理后获得动脉期、门脉期血管图像：分析肝癌的多层螺旋CT血管成像的表现，并与DSA图像、手术所见以及其临床随访结果相对照。结果MSCTA能够清晰显示肝癌供血动脉形态、起源，并显示瘤体内肿瘤血管和肿瘤染色以及动静脉瘘：能准确评价肝动脉1～2级肿瘤供血血管，但对肝动脉3级分支供血血管显示欠佳；其显示肿瘤供血动脉的敏感度为93.55％，特异度为97.50％，阳性预报值为96.67％，阴性预报值为90.70％。同时MSCTA还显示门静脉血管的形态、变异以及受侵犯的状况，其诊断的敏感度为98.00％，特异度为93.94％，阳性预报值96.09％，阴性预报值为96.67％。结论MSCTA能够提供大量关于肝癌肿瘤供血动脉和血管受累的信息，可作为肝癌治疗前进行准确术前分期和制定手术或者治疗方案的最有效的影像学检查方法。更多还原

【Abstract】 Objective: To analyze the imaging findings of primary hepatocellar carcinoma. With Multi-slice Spiral CT Angiography(MSCTA) , and to evaluate the clinical application of MSCTA. Methods: 83 cases with hepatocellular carcinoma (HCC) confirmed by pathologic or surgical results or clinical follow up were studied with MSCT. MSCTA images were acquired by post processing of the original data on advanced workstation. The images of MSCTA were analyzed and compared with the findings of DSA, surgery and other imaging modalities. Results: MSCTA clearly showed the tumor vessels and tumor stain as well as hepatic-portal fistula of HCC and easily detect the origin、 shape of tumor supplying arteries. As far as tumor supplying vessels MSCTA illustrated the 1~2 grade branches of hepatic arteries much better than 3 grade branches. The sensitivity, specificity, positive predicted value (PPV) and negative predicted value (NPV) of MSCTA in detecting the tumor supplying arteries were 93.55% ,97.50%, 96. 67%, 90.70%, respectively. Simultaneously, MSCTA also displayed the variation and invasion situation of portal vein system. The sensitivity, specificity, positive predicted value (PPV) and negative predicted value (NPV) of MSCTA in evaluating portal vein involved by HCC were 98.00%, 93.94%, 96. 09% and 96. 67%, respectively. Conclusion: MSCTA更多还原