(广东省汕头市第二人民医院放射科， 广东 汕头 515011)

    摘 要：目的：分析小肝癌在螺旋CT三期(动脉期、门脉期和延迟期)增强扫描的表现，比较各期的病灶检出率，提高小肝癌的诊断水平。方法：18例小肝癌分别行多层螺旋CT平扫及三期增强扫描，扫描时间分别为动脉期25s、门脉期70s、延迟期5min，用高压注射器经肘静脉注射，速率为3 ml/s，剂量为1.5 ml/kg。结果：共发现20个病灶，动脉期、门脉期和延迟期的检出率分别为80%，60%和65%。动脉期的敏感性高于门脉期和延迟期。三期联合后检出率明显增加达95%。结论：多层螺旋CT三期增强扫描能反映出小肝癌血供特点和表现，使其早期诊断成为可能。

    关键词： 多层螺旋CT； 三期增强扫描； 小肝癌

    The Diagnosis of Small Hepatocellular Carcinoma with Multiphase Spiral CT Scan

    DONG Guan-wei， FU Hua-nian， LIU Shi-zhong

    (The No.2 Hospital of Shantou City, Guangdong Shantou 515011, China)

    Abstract： Objective: To investigate the features of the enhancement of small hepatocellular carcinoma (SHCC) at multiphase spiral CT scanning and compare the sensitivity of detection in different phases. Method: 18 patients with small hepatocellular carcinoma (SHCC) underwent plain scan and the third scan with multiphase spiral CT. The scan delay time for arterial phase, portal venous phase and lag phase was 25s, 70s and 5min respectively. Injecting the contrast medium into the ulnar vein with the high-pressure syringe, the velocity was 3ml/s, and the dose was 1.5ml/kg. Results: 20 cases of SHCC were detected totally, and the sensitivity of detection in three phases was 80%, 60% and 65% respectively. The sensitivity increased significantly to 95% by combining the detection of three phases. Conclusion: The multiphase spiral CT scan can display the feature of blood supply in early diagnosis of SHCC. Multiphase spiral CT can fully demonstrate the patterns of SHCC and improve the detection sensitivity. ......