三维立体图像判定肝占位病变性质的意义  

The significance of hepatic occupying lesions properties assessed by hepatic blood pool three-dimensional image

作　　者：张彩霞[1] 李志杰[1] 徐微娜 李剑明 刘长平 夏雁君 尹丽 

机构地区：[1]中国医科大学第二临床学院核医学科,辽宁沈阳110003

出　　处：《中国临床医学影像杂志》2000年第1期20-22,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:用肝血池三维(3D)立体图像,判定肝占位病变的性质。方法:对45例肝占位病变患者,做肝核素显像检查,并建立三维立体图像,判定其性质;再与肝血流灌注相的早期充盈、时间活性曲线(TAC)、肝血池(平面及断层)显像、CT和彩超检查作对照。结果:28例肝血管瘤:肝血池3D立体图像确诊27例,平面图像确诊22例,断层图像确诊24例,均显示过度充填;27例TAC高峰左移,高度增加;CT确诊23例,彩超24例。8例肝癌:肝血池3D立体图像确诊6例,平面图像确诊5例,断层图像确诊6例,充填为阴性;肝血流灌注相均有早期充盈,TAC高峰右移;CT及彩超确诊6例。肝良性病变(囊肿6例,实质性病变3例):3D立体图像、平面、断层图像充填阴性7例(囊肿4例,实质性病变3例);肝血流灌注相均无早期充盈,TAC呈持续低下曲线;彩超确诊7例(囊肿6例,实质性病变1例);CT确诊7例(囊肿5例,实质性病变2例)。结论:肝血池3D立体图像,对肝血管瘤诊断灵敏度高;肝血流灌注相早期充盈、TAC高峰变化,对判定肝占位病变的良恶性有十分重要的意义。Objective:Using hepatic blood pool three dimensional (3D) image,to assess properties of hepatic occupying lesions.Methods:45 cases with hepatic occupying lesions were examined by 3D.Their properties were assessed.Hepatic blood flow earlier perfusion phase,time-activity curve(TAC),hepatic blood pool phase(plane and tomography),CT and color ultrasound were compared as control group.Results:Among 28 cases with hemangioma:27 cases were diagnosed by 3D,22 cases by plane,24 cases by tomography,their hepatic blood pool were all filled,the spike of TAC shifting left with height increased;23 cases were diagnosed by CT,24 cases were diagnosed by color ultrasound;In 8 cases with hepatic cells carcinoma:hepatic blood pool phase were negative,6 cases were diagnosed by 3D,5 cases by plane,6 cases by tomography,the hepatic blood perfusion were filled earlier with spike of TAC shifting rightly and ,but 6 cases were diagnosed by CT and color ultrasound;In 9 cases with hepatic cyst and benign diseases:the early hepatic blood perfusion imaging had not filled,TAC was sustained lower ,7 cases did not filled in 3D,hepatic blood perfusion phase and hepatic blood pool phase(4 cases with hepatic cyst,3 cases with hepatic benign diseases);6 cases with hepatic cyst,1 case with parenchymatous lesion were diagnosed by color ultrasound ,but 5 cases with hepatic cyst 2 cases with benign lesion were diagnosed by CT.Conclusion:Hepatic blood pool 3D image was specificity for diagnosing hemangioma.Hepatic blood perfusion imaging filled early and spike change of TAC has significance in differential diagnosis for hepatic benign and malignant diseases.

关 键 词：三维立体图像 时间-活性曲线 肝占位病变 

分 类 号：R817.45[医药卫生—影像医学与核医学]