肝脏异常灌注在肝肿瘤CT诊断中的意义  

The significance of hepatic perfusion disorders in CT diagnosis of liver tumor

作　　者：王立平[1] 孟祥鸿[2] 李树艳[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院CT室,黑龙江哈尔滨150001 [2]无锡市中医医院,江苏无锡214001

出　　处：《哈尔滨医科大学学报》2008年第4期406-408,F0004,共4页Journal of Harbin Medical University

摘　　要：目的探讨肝脏肿瘤伴肝脏实质异常灌注的表现及机制。方法回顾分析有异常灌注的56例肝肿瘤的增强表现,肿瘤类型经手术病理、特征性影像学表现及病情随访确诊,包括原发性肝细胞癌33例、肝内胆管细胞癌5例、转移瘤12例、肝血管瘤6例。结果原发性肝癌及胆管细胞癌的异常灌注可发生在肝门区或肝周边部分,呈楔形、片状或节段性,伴门静脉瘤栓29例,动静脉短路19例;肝血管瘤异常灌注表现为肝动脉期瘤周肝实质的楔形、不规则形或节段性高密度;转移瘤中包括肝癌肝内转移6例,其余6例,异常灌注表现为动脉期瘤周环形高密度。结论肝内异常灌注及伴发征象的出现有助于肿瘤的诊断与鉴别诊断,并对了解肝脏血供的变化有意义,从而指导临床治疗。Objective liver tumor. Methods To study the CT findings and mechanism of hepatic perfusion disorders （HPD） of The hepatic perfusion images of 56 patients with liver tumor were retrospectively analyzed. The type of tumor were proved in the sides of pathology, imageology and follow-up. The cases included 33 hepatic cell carcinomas, 5 intrahepatic cholangiocellular carcinomas, 12 metastatic tumors and 6 hemangiomas of liver. Results The hepatic perfusional disorder in the hepatic cell carcinoma and cholangiocellular carcinoma were looked in hepatic hilar region or hepar periphery, like wedge shape, lamellar or segment. Among them, there were 29 cases with portal venous tumor embolus and 19 ones with AV shunt. The images of the HPD in hemangiomas of liver showed the shape, lamellar or segmental high-density. The images of the HPD in metastatic tumor showed ring - shaped high density around them. Conclusion It is conduce to diagnosis of hepatic tumor being proved through the sign of hepatic perfusion disorders and accompanyed symptom, to move forward a single step to learn the variation of blood supply within liver. Moreover; the hepatic perfusion can direct clinical treatment.

关 键 词：肝脏肿瘤 异常灌注 体层摄影 X线计算机 

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]