Lim Jae Hoon, Kim Min Ju, Chiang Liu Wei, Lim Hyo Keun, Park Cheol Keun, Paik Seung Woon, Koh Kwang Cheol, Joh Jae Won
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Taehan Kan Hakhoe Chi. 2002 Jun;8(2):201-8.
The objective of this study was evaluate the diagnostic efficacy of three-phase helical dynamic CT in the detection of hepatocellular carcinomas in patients with advanced liver cirrhosis.
Three-phase helical dynamic CT in 77 patients with advanced liver cirrhosis was evaluated prospectively before orthotopic liver transplantation. The histopathologically confirmed hepatocellular carcinomas in the explanted livers were compared with pretransplantation CT results by one-to-one correlation.
Histopathologic examination of the explanted livers revealed 72 hepatocellular carcinomas in 41 patients. The size of the hepatocellular carcinomas was 0.5-14.0 cm (mean, 1.6 cm). The use of helical dynamic CT enabled the detection of 38 of 72 hepatocellular carcinomas (sensitivity, 53%). Fifteen of 35 (43%) hepatocellular carcinomas smaller than 2 cm and 23 of 37 (62%), hepatocellular carcinomas ranging from 2.0 cm to 14.0 cm were detected. Patient sensitivity and specificity in the detection of hepatocellular carcinoma were 81% (33/41) and 94% (34/36), respectively.
Three-phase helical dynamic CT is insensitive for detection of hepatocellular carcinomas in patients with advanced liver cirrhosis, especially for hepatocellular carcinomas smaller than 2 cm.
本研究的目的是评估三期螺旋动态CT在检测晚期肝硬化患者肝细胞癌中的诊断效能。
前瞻性评估77例晚期肝硬化患者在原位肝移植术前的三期螺旋动态CT。将移植肝中经组织病理学证实的肝细胞癌与移植前CT结果进行逐一对照。
移植肝的组织病理学检查显示41例患者中有72个肝细胞癌。肝细胞癌的大小为0.5 - 14.0 cm（平均1.6 cm）。使用螺旋动态CT能够检测出72个肝细胞癌中的38个（敏感性为53%）。在小于2 cm的35个肝细胞癌中检测出15个（43%），在2.0 cm至14.0 cm的37个肝细胞癌中检测出23个（62%）。检测肝细胞癌的患者敏感性和特异性分别为81%（33/41）和94%（34/36）。
三期螺旋动态CT对晚期肝硬化患者肝细胞癌的检测不敏感，尤其是对小于2 cm的肝细胞癌。
