CT灌注成像对原发性肝癌、肝转移瘤和肝血管瘤的鉴别诊断价值  

Differential value of CT perfusion imaging in hepatocellular carcinomas,hepatic metastastes and hemoangiomas

作　　者：薛敏娜[1] 白人驹[2] 李丰坦[2] 付俊杰[2] 张翔[3] 孙孟瑞[3] 

机构地区：[1]天津市第二医院放射科,300141 [2]天津医科大学总医院放射科 [3]天津市第三中心医院

出　　处：《国外医学（临床放射学分册）》2008年第3期152-155,217,共5页

摘　　要：目的探讨CT灌注成像对原发性肝癌、肝转移瘤和肝血管瘤的鉴别诊断价值。方法对24例原发性肝癌、11例肝转移瘤和21例肝血管瘤的病灶实性部分,周围肝实质以及正常肝实质的CT灌注参数进行分析。结果比较各组病灶实质部分的参数,原发性肝癌组的肝血流量(HBF)、肝动脉灌注分数(HAF)明显高于肝转移瘤组和肝血管瘤组,原发性肝癌和肝血管瘤组的肝血容量(HBV)高于肝转移瘤组,原发性肝癌组的平均通过时间(MTT)则依次短于肝转移瘤组、血管瘤组,三组间的毛细血管表面通透性(PS)无显著性差异;比较病灶周围实质部分的参数,原发性肝癌组和肝转移瘤组的HBF明显高于肝血管瘤组,而HAF均低于肝血管瘤组,肝转移瘤组的PS高于肝血管瘤组,三组间的HBV、MTT无显著性差异;对于正常肝实质部分,原发性肝癌组的MTT短于肝转移瘤组和肝血管瘤组,原发性肝癌组的HAF高于肝转移瘤组和肝血管瘤组,三组间的HBF、HBV、PS无显著性差异。结论CT灌注成像灌注参数值的测定对于原发性肝癌、肝转移瘤和肝血管瘤的鉴别诊断以及对邻近的肝组织受累情况的评估具有重要的临床意义。Objective To evaluate the differential value of CT perfusion imaging （CTPI） in hepatocellular carcinomas （HCC）, hepatic metastastes （HM）, and hemoangiomas （HA）. Methods 24 patients with HCC, 11 patients with HM and 21 patients with hemoangiomas underwent CTPI on a 16-slice CT, The perfusion parameters which were calculated with liver tumor mode were measured in the solid portion, adjacent invasion and parachyma with normal appearance. Results The hepatic blood flow （HBF） and hepatic arterial fraction （HAF） in the solid portion were significantly much higher in HCC group than that of HM and HA groups, The hepatic blood volume （HBV） were significantly higher in HCC and HA groups than that of HM group. The mean transit time （MTT） was significantly lower in HCC group than that of riM and HA groups, In the adjacent parachyma, the HBF were significantly higher and the HAF were significantly lower in the HCC and HM groups than that of HA group. The capillary vessel surface （PS） was significantly higher in HM group than that of HA group, There were no statistical differences in HBV and MTT among the three groups. In the parachyma with normal appearance,the MTT was significantly decreased and the HAF was significantly increased in HCC group compared with HM and HA. There were no statistical differences in HBF,HBV and PS among the three groups. Conclusion The change of CTPI parameters of HCC, HM and HA are of great values in the differential diagnosis and the evaluation of adjacent invasion of hepatic malignancies.

关 键 词：CT灌注成像 原发性肝癌 肝转移瘤 血管瘤 

分 类 号：R814.42[医药卫生—影像医学与核医学] R735.7[医药卫生—放射医学]