中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2011年
4期
250-254
,共5页
肝%局灶性结节增生%放射性核素显像%体层摄影术,X线计算机%99m锝硫胶%EHIDA
肝%跼竈性結節增生%放射性覈素顯像%體層攝影術,X線計算機%99m锝硫膠%EHIDA
간%국조성결절증생%방사성핵소현상%체층섭영술,X선계산궤%99m득류효%EHIDA
Liver%Focal nodular hyperplasia%Radionuclide imaging%Tomography,X-ray computed%Technetium Tc 99m sulfur colloid%EHIDA
目的 分析放射性核素显像和常规CT诊断肝局灶性结节增生(FNH)的各自优势,探讨二者结合对FNH的诊断价值.方法 回顾性分析32例(男15例,女17例,年龄22～59岁)FNH患者的病理及影像资料.32例患者均行常规CT(平扫及增强)检查.其中24例行放射性核素显像,在肝胶体显像时加做融合图像采集,经计算机处理后得到SPECT及定位CT的融合图像.对显像发现病灶的患者行肝胆动态显像,包括血流灌注相、早期相及延迟相.检查结果的比较采用四格表x2检验或四格表Fisher确切概率法检验.结果 32例患者共切除32个病灶,均为单发.病理均为FNH,其中25个为病理经典型,7个为病理非经典型;大病灶(最大径＞3 cm)20个,小病灶(最大径≤3 cm)12个.32例患者常规CT检出所有病灶,确诊病理经典型FNH 15个,其中大病灶10个,小病灶5个;其余病灶均误诊或诊断不明确.24例患者进行放射性核素显像,结果示大病灶11个,其中病理经典型7个,病理非经典型4个;其余病灶诊断不明确或未检出.常规CT与放射性核素显像对病理经典型病灶确诊率分别为60.0%(15/25)和38.9%(7/18),病理非经典型为0/7和4/6;大病灶为50.0%(10/20)和73.3%(11/15),小病灶为41.7%(5/12)和0/9;对FNH的总确诊率为46.9%(15/32)和45.8%(11/24).24例行放射性核素显像患者同时行常规CT检查,2种方法结合共确诊FNH 18个,总确诊率75.0%(18/24).在病理非经典型、小病灶FNH的诊断方面,常规CT与放射性核素显像比较,差异有统计学意义(P=0.02,0.04);2种方法结合对FNH的总确诊率与单种方法的确诊率比较,差异均有统计学意义(x2=4.48和4.27,P均＜0.05).结论 常规CT与放射性核素显像对FNH的诊断各有优势;二者结合可提高对FNH的总确诊率.
目的 分析放射性覈素顯像和常規CT診斷肝跼竈性結節增生(FNH)的各自優勢,探討二者結閤對FNH的診斷價值.方法 迴顧性分析32例(男15例,女17例,年齡22～59歲)FNH患者的病理及影像資料.32例患者均行常規CT(平掃及增彊)檢查.其中24例行放射性覈素顯像,在肝膠體顯像時加做融閤圖像採集,經計算機處理後得到SPECT及定位CT的融閤圖像.對顯像髮現病竈的患者行肝膽動態顯像,包括血流灌註相、早期相及延遲相.檢查結果的比較採用四格錶x2檢驗或四格錶Fisher確切概率法檢驗.結果 32例患者共切除32箇病竈,均為單髮.病理均為FNH,其中25箇為病理經典型,7箇為病理非經典型;大病竈(最大徑＞3 cm)20箇,小病竈(最大徑≤3 cm)12箇.32例患者常規CT檢齣所有病竈,確診病理經典型FNH 15箇,其中大病竈10箇,小病竈5箇;其餘病竈均誤診或診斷不明確.24例患者進行放射性覈素顯像,結果示大病竈11箇,其中病理經典型7箇,病理非經典型4箇;其餘病竈診斷不明確或未檢齣.常規CT與放射性覈素顯像對病理經典型病竈確診率分彆為60.0%(15/25)和38.9%(7/18),病理非經典型為0/7和4/6;大病竈為50.0%(10/20)和73.3%(11/15),小病竈為41.7%(5/12)和0/9;對FNH的總確診率為46.9%(15/32)和45.8%(11/24).24例行放射性覈素顯像患者同時行常規CT檢查,2種方法結閤共確診FNH 18箇,總確診率75.0%(18/24).在病理非經典型、小病竈FNH的診斷方麵,常規CT與放射性覈素顯像比較,差異有統計學意義(P=0.02,0.04);2種方法結閤對FNH的總確診率與單種方法的確診率比較,差異均有統計學意義(x2=4.48和4.27,P均＜0.05).結論 常規CT與放射性覈素顯像對FNH的診斷各有優勢;二者結閤可提高對FNH的總確診率.
목적 분석방사성핵소현상화상규CT진단간국조성결절증생(FNH)적각자우세,탐토이자결합대FNH적진단개치.방법 회고성분석32례(남15례,녀17례,년령22～59세)FNH환자적병리급영상자료.32례환자균행상규CT(평소급증강)검사.기중24례행방사성핵소현상,재간효체현상시가주융합도상채집,경계산궤처리후득도SPECT급정위CT적융합도상.대현상발현병조적환자행간담동태현상,포괄혈류관주상、조기상급연지상.검사결과적비교채용사격표x2검험혹사격표Fisher학절개솔법검험.결과 32례환자공절제32개병조,균위단발.병리균위FNH,기중25개위병리경전형,7개위병리비경전형;대병조(최대경＞3 cm)20개,소병조(최대경≤3 cm)12개.32례환자상규CT검출소유병조,학진병리경전형FNH 15개,기중대병조10개,소병조5개;기여병조균오진혹진단불명학.24례환자진행방사성핵소현상,결과시대병조11개,기중병리경전형7개,병리비경전형4개;기여병조진단불명학혹미검출.상규CT여방사성핵소현상대병리경전형병조학진솔분별위60.0%(15/25)화38.9%(7/18),병리비경전형위0/7화4/6;대병조위50.0%(10/20)화73.3%(11/15),소병조위41.7%(5/12)화0/9;대FNH적총학진솔위46.9%(15/32)화45.8%(11/24).24례행방사성핵소현상환자동시행상규CT검사,2충방법결합공학진FNH 18개,총학진솔75.0%(18/24).재병리비경전형、소병조FNH적진단방면,상규CT여방사성핵소현상비교,차이유통계학의의(P=0.02,0.04);2충방법결합대FNH적총학진솔여단충방법적학진솔비교,차이균유통계학의의(x2=4.48화4.27,P균＜0.05).결론 상규CT여방사성핵소현상대FNH적진단각유우세;이자결합가제고대FNH적총학진솔.
Objective To investigate radionuclide imaging and routine CT in diagnosing hepatic focal nodular hyperplasia (FNH) and the combined diagnostic value of the two modalities. Methods Thirty-two patients with hepatic FNH were retrospectively studied. All patients underwent routine CT scan. Twenty-four patients were examined by 99Tcm-sulfur colloid (SC) hepatic planar scintigraphy and SPECT/CT imaging, and then patients who had abnormal foci underwent 99Tcm-diethyl iminodiacetic acid (EHIDA) triple-phase hepatobiliary imaging. x2 -test of four-table or Fisher exact probabilities in 2 × 2 table was applied for statistical analysis. Results Of all 32 patients pathologically diagnosed as FNH with single solitary nodule, 25 were classified as classic type and the rest 7 as non-classic type. Although routine CT found all hepatic lesions, only 15 cases were diagnosed pathologically as FNH classic type but the rest were either misdiagnosed or left as indeterminate. On radionuclide imaging (hepatic colloid scintigraphy plus triple-phase hepatobiliary images), 11 patients with big foci (with maximal diameter ＞3 cm) out of 24 patients were correctly diagnosed as FNH, with 7 diagnosed as classic type FNH and 4 as non-classic. Other 13 patients were either misdiagnosed or simply missed. The diagnosing rates of routine CT and radionuclide imaging were60.0% (15/25) and 38.9% (7/18) for FNH classic type, 0/7 and 4/6 for non-classic type,50.0% (10/20) and 73.3% (11/15) for big foci, 41.7% (5/12) and 0/9 forsmall foci (with maximal diameter≤3 cm), respectively. The total diagnosing rate of radionuclide imaging combined with routine CT was significantly higher than that of routine CT or radionuclide imaging alone ( x2 = 4. 48, P ＜ 0. 05;x2 =4.27, P ＜0.05 ). Conclusion Radionuclide imaging in combination with routine CT may improve the diagnostic accuracy for hepatic FNH patients.
