目的 研究螺旋CT多期增强扫描 对肝转移瘤的应用价值。方法 选取我院 2015年1月到2016年1月经过多层螺旋CT 多期扫描检查的肝转移瘤患者103例进行 图像分析。先行碘过敏试验，之后患者 取仰卧位行CT检查，仪器为东芝320排容 积CT，常规平扫后行标准动态三期扫描, 使用高压注射器团注法经上肢静脉一次 性团注非离子型对(300mgI/ml),用量 80～100ml，注射速度为2.5-3.0ml/s， 注射对比剂后20～30s为动脉期,40～60s 为门脉期,150～180s为平衡期。结果 其 中动脉期边缘强化552个病灶，门脉期边 缘强化549个病灶，平衡期边缘强化452 个病灶，最后得出动脉期平衡期三组之 间对病灶边缘强化显示率的关系为：动 脉期=门脉期＞平衡期(门脉期与动脉期 两组间P＞0.05，差别没有特别意义)； 三组对病灶内部与病灶周围肝实质间密 度差的表现率关系为:门脉期＞动脉期＞ 平衡期。结论 利用多层螺旋CT的优越性 能,有利于肝转移瘤的检出、筛查、诊断 以及鉴别诊断。可显著提高临床诊断率, 避免病灶误诊的发生,对肿瘤具有增强信 息的作用,可为临床诊断提供重要的参考 依据。

Objective To study the application value of spiral CT multi-phase enhanced scan in liver metastases. Methods The images of 103 patients with liver metastases who underwent spiral CT multi-phase enhanced scan in our hospital between January 2015 and January 2016 in our hospital were analyzed.Firstly, the patients underwent iodine allergy test and then they underwent CT examination in supine position, and the instrument was Toshiba 320-slice volume CT. After routine plain scan, standard dynamic three-phase scanning was performed. 80~100ml of nonionic contrast agent (300mgI/ml) was injected by upper intravenous bolus injection with high pressure injector, and the injection rate was 2.5~3.0ml/s. 20~30s after injection of contrast agent was arterial phase while 40~60s was portal phase and 150~180s was equilibrium phase. Results There were 552 lesions with marginal enhancement in arterial phase, 549 lesions in portal phase and 452 lesions in equilibrium phase. The relationship between the display rates of marginal enhancement between groups in arterial phase and equilibrium phase was arterial phase=portal phase＞ equilibrium phase (P＞0.05), the display rates of internal lesions and density differences of liver parenchyma around the lesions showed portal phase＞arterial phase＞equilibrium phase. Conclusion Multi-slice spiral CT is helpful to the detection, screening, diagnosis and differential diagnosis of liver metastases. It can significantly improve the clinical diagnostic rate, avoid the occurrence of misdiagnosis and enhance the role of information, which provides an important reference for clinical diagnosis.