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目的：探讨双期动态ＣＴ对肝肿瘤诊断的价值。方法：４８例肝肿瘤患者平扫发现并定位病灶后，用压力注射器以３ｍｌ／ｓ速度从肘静脉经１７号塑料套管针注入造影剂６０ｍｌ，开始注射后１４ｓ行双期动态ＣＴ，同层共扫７次。结果：本方法对原发肝癌、肝血管瘤和肝转移癌的定性诊断准确性分别为９５．７％、１００％和８０％，均明显高于普通增强ＣＴ（Ｐ＜０．０５）。原发肝癌的典型表现是动脉期病灶内结节状、片状强化，并可见肿瘤血管影，强化部分在静脉期迅速呈低密度影；肝血管瘤的特征性表现为动脉期病灶边缘结节状强化，密度类似于主动脉或肝动脉，静脉期强化结节逐渐向病灶中央扩展；肝转移癌的主要表现为动、静脉期病灶边缘环状强化，中央部分无明显强化，静脉期还可见到“牛眼征”。结论：双期动态ＣＴ能获取肝肿瘤的特征性表现，可作为肝脏肿瘤常规的检查方法
Objective: To investigate the value of double-phase dynamic CT in the diagnosis of liver tumors. Methods: Forty-eight patients with liver cancer were found by plain scanning and focal lesion. 60ml of contrast medium was injected into the elbow vein through the 17th plastic cannula with a pressure syringe at a rate of 3ml / s. The double-phase dynamic CT was performed 14s after the start of injection. Scan a total of 7 times. Results: The diagnostic accuracy of this method for primary hepatocellular carcinoma, hepatic hemangioma and metastatic liver cancer was 95.7%, 100% and 80%, respectively, which were significantly higher than that of normal enhanced CT (P <0.05). The typical manifestation of primary liver cancer is intra-arterial nodules within the lesion, sheet-like enhancement, and visible tumor angiogenesis, enhanced part of the venous phase was rapidly low density; hepatic hemangioma is characterized by lesions of the edge of the nodules Like enhancement of the aorta or hepatic artery. The intensive nodules in the venous phase gradually expanded to the center of the lesion. The main manifestations of hepatic metastasis were the annular enhancement at the margin of the arteriovenous and venous phase, no obvious enhancement in the central part and the venous phase To “bull’s eye sign.” Conclusions: Two-phase dynamic CT can obtain the characteristic manifestation of liver tumor and can be used as a routine examination method of liver tumor