| Objective:To discuss the value of spiral CT and digital subtraction angiography (DSA) in the diagnosis of ruptured hepatocellular carcinoma (HCC).Materials and methods:The images including 42 spiral CT and 94 DSA examinations of 108 patients with ruptured HCC were retrospectively analyzed. 21 patients underwent both spiral CT and DSA examinations.94 patients underwent selective and superselective hepatic artery angiography. The imaging diagnosis of ruptured HCC were common confirmed by two radiologists. The positive signs of the two methods in detecting the rupture of HCC were summarized and the detection rates of the two methods were compared. The detection rates of selective and superselective hepatic angiography were also compared.Results:40 patients with ruptured HCC were confirmed by spiral CT examinations (40/42) with the positive signs including hemoperitoneum, surrounding hematoma, active extravasation of contrast materials, discontinuity of the hepatic surface and the enucleation sign. The positive rate was 95.2%.37 cases were confirmed by DSA (37/94) with the positive signs including spurting arteries, sprinkling arterioles and capillaries. The positive rate was 41.5%. The two metheds were significantly different (P<0.05). The two metheds were also significantly different in 21 patients who underwent both spiral CT and DSA examinations (P<0.05). All of the 21 patients were confired by spiral CT (100%), while 6 cases by DSA (28.6%). The selective hepatic angiography detected 15 cases(16.0%) and the superselective hepatic angiography detected 35 cases(37.2%) in the 94 patients who underwent both. There was a significant difference between selective and superselective hepatic angiography (P<0.05).Conclusion:Spiral CT demonstrates a higher positive rate than DSA in diagnosis of the rupture of hepatocellular carcinoma. The superselective hepatic angiography has a higher positive rate than selective hepatic angiography. |
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