Wang J, Tsang Y M, Lee P H, Wei T C, Lai M Y, Hsu H C, Chen D S
Department of Medical Imaging, College of Medicine, National Taiwan University Hospital, Taipei.
J Formos Med Assoc. 1997 Dec;96(12):955-61.
Computed tomography (CT) during arterial portography (CTAP) is useful in detecting hepatic tumors but cirrhotic change may interfere with portal flow and the prediction of resectability. We evaluated the usefulness of CTAP in detecting hepatic tumors, especially hepatocellular carcinoma (HCC), in patients with or without cirrhotic change. Ninety-six patients with pathologically proven hepatic tumors were assessed, of whom 90 had hepatocellular carcinoma. The tumors had been previously detected by abdominal ultrasound and CT scans, after which the patients were referred for angiography and CTAP. The CTAP findings were compared with ultrasonographic, conventional CT, angiographic, and subsequent surgical and pathologic findings regarding size, number, and location of the hepatic lesions. CTAP detected 134 of 143 pathologically proven lesions. The overall sensitivity of CTAP in the 96 patients was 94%, with a false-positive rate of 22%. The detection rate of CTAP for tumors less than 2 cm in diameter was high (92%). The sensitivity and false-positive rate for CTAP in 60 cirrhotic patients were 94% and 23%, respectively, CTAP is a sensitive imaging modality for detection of hepatic neoplasms even in patients with cirrhosis, but its false-positive rate is high.
动脉性门静脉造影CT（CTAP）在检测肝脏肿瘤方面很有用，但肝硬化改变可能会干扰门静脉血流以及对可切除性的预测。我们评估了CTAP在检测有无肝硬化改变的患者肝脏肿瘤，尤其是肝细胞癌（HCC）方面的实用性。对96例经病理证实有肝脏肿瘤的患者进行了评估，其中90例为肝细胞癌。这些肿瘤此前已通过腹部超声和CT扫描检测到，之后患者被转诊进行血管造影和CTAP检查。将CTAP的检查结果与超声、传统CT、血管造影以及后续手术和病理检查结果在肝脏病变的大小、数量和位置方面进行了比较。CTAP检测出了143个经病理证实病变中的134个。CTAP在96例患者中的总体敏感性为94%，假阳性率为22%。CTAP对直径小于2cm肿瘤的检出率很高（92%）。CTAP在60例肝硬化患者中的敏感性和假阳性率分别为94%和23%。即使对于肝硬化患者，CTAP也是检测肝脏肿瘤的一种敏感成像方式，但其假阳性率较高。
