多层螺旋CT动态增强扫描对肝细胞癌合并肝动脉—门静脉瘘的诊断价值
肝细胞癌；门静脉；肝动脉；体层摄影术,螺旋计算机,,],肝细胞癌；门静脉；肝动脉；体层摄影术，螺旋计算机,1资料与方法,2结果,3讨论,[参考文献]
[摘要] 目的 探讨多层螺旋CT动态增强扫描对肝细胞癌合并肝动脉—门静脉瘘的诊断价值。 方法 52例肝细胞癌患者均进行肝脏3期动态增强扫描，延迟时间分别为27 s、60 s、90 s。结果 52例肝细胞癌中，发现18例合并肝动脉—门静脉瘘，占34.6%(18/52)，其中中央型6例，周围型12例。中央型6例均发现门静脉主干和(或)1级分支内癌栓形成，周围型12例中，8例CT血管成像表现为门静脉2级以下分支连续性中断，呈截断征，4例CT血管成像表现为门静脉分支与肝动脉分支伴行，呈双轨征。本组病例中，肝动脉—门静脉瘘的检出率为34.6%，与文献报道相比偏低。 结论 多层螺旋CT动态增强扫描及血管重建对肝细胞癌合并肝动脉—门静脉瘘具有较高的诊断价值，CT血管成像能清楚的显示分流的门静脉及其分支，供血动脉与肝动脉之间的关系，对临床确定治疗方案具有重要的指导作用。[关键词] 肝细胞癌；门静脉；肝动脉；体层摄影术，螺旋计算机
Diagnostic value of multiple spiral CT dynamic contrastenhanced scan for arterioportal shunt in hepatocellular carcinoma
MU Qingjin.CT Department，The First Peoples Hospital of Qujing,Yunnan 655000,China
[Abstract] Objective To investigate the value of multiple spiral CT dynamic contrastenhanced scan in diagnosis of arterioportal shunt in hepatocellular carcinoma. Methods 52 patients with hepatocellular carcinoma were all checked with multislice spiral CT three stages dynamic contrast enhancement scan and the delayed time is 27 seconds,60 seconds and 90 seconds. Results In this 52 patients with hepatocellular carcinoma,18 cases complicated with arterioportal shunt (34.6%) and in this group,12 cases are peripheral and 6 cases are central.Moreover,this 6 central patients are all complicated with portal vein tumor thrombus and in this 12 peripheral cases,8 cases appears interrupt and the portal vein looks like “interruption”;4 patients appears accompanying between portal vein and hepatic artery and it looks like “doubleway”.In this group,the imaging finds ratio of arterioportal shunt in hepatocellular carcinoma are 34.6%,and it is lower compared with the reports. Conclusion Multiple spiral CT dynamic contrastenhanced scan and angiography can really supply effective value in diagnosing arterioportal shunt in hepatocellular carcinoma.The portal vein and its branch,the relationship between arteries can be clearly appeared by spiral CT angiography. ......
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