Yan Weiqiang, Liu Pengcheng, Gao Wenqing, Liu Yuanjian, Zhao Yan, Zou Liqiu, Jiang Guoyin, Yuan Zhidong
Department of Radiology, Shenzhen Hospital, Peking University, Shenzhen 518036, China.
Zhonghua Zhong Liu Za Zhi. 2002 Nov;24(6):585-8.
To analyze the cause of atypical manifestation of hepatocellular carcinoma (HCC) in triple-phase spiral CT enhanced scan.
Triple-phase spiral CT scan was performed in 75 patients with HCC. The hepatic arterial phase (HAP), portal venous phase (PVP) and delayed phase (DP) images were started at 25 to 30 s, 65 to 70 s and 3 tp 5 min after injection of contrast medium. The contrast enhanced patterns of lesion were observed and analyzed.
Ninety-two lesions were found in 75 patients. Typical enhanced findings such as hyperdense in HAP and hypodense in PVP and DP was found in 60 of 92 lesions. Atypical enhanced findings were observed in the other 32 lesions. Fourteen of 32 atypical enhanced lesions were hyperdense in HAP and isodense in PVP, of which 8 were seen in liver cirrhosis and 3 in fatty liver. In DP, 10 were hypodense and 4 still isodense. Eight of the 32 lesions were hyperdense both in HAP and PVP, of which 6 were seen in fatty liver. In DP, 3 were isodense and 5 were hypodense. Six of 32 lesions were isodense in HAP which became hypodense in PVP and DP. Four of 32 lesions were all hypodense in HAP, PVP and DP.
Multiple atypical enhanced manifestations are present by triple-phase spiral CT scan in HCC. Pattern of blood supply, scanning technique and pathophysiologic status are usually the cause of these findings.
分析肝细胞癌（HCC）在螺旋CT三期增强扫描中表现不典型的原因。
对75例HCC患者进行螺旋CT三期扫描。在注射造影剂后25至30秒、65至70秒及3至5分钟分别开始采集肝动脉期（HAP）、门静脉期（PVP）及延迟期（DP）图像。观察并分析病灶的强化方式。
75例患者共发现92个病灶。92个病灶中有60个表现为典型强化，即HAP期高密度，PVP期及DP期低密度。另外32个病灶表现为不典型强化。32个不典型强化病灶中，14个在HAP期为高密度，PVP期为等密度，其中8个见于肝硬化患者，3个见于脂肪肝患者。在DP期，10个为低密度，4个仍为等密度。32个病灶中有8个在HAP期及PVP期均为高密度，其中6个见于脂肪肝患者。在DP期，3个为等密度，5个为低密度。32个病灶中有6个在HAP期为等密度，在PVP期及DP期变为低密度。32个病灶中有4个在HAP期、PVP期及DP期均为低密度。
HCC在螺旋CT三期扫描中存在多种不典型强化表现。血供方式、扫描技术及病理生理状态通常是这些表现的原因。
