64层螺旋CT灌注成像在肝细胞癌诊断中的应用  

Application of 64-slice spiral CT perfusion imaging in the diagnosis of hepatocellular carcinoma

作　　者：丁可[1] 杨新官[1] 吴嘉兴[2] 曾阳东[1] 

机构地区：[1]桂林医学院附属医院放射科,广西桂林541001 [2]桂林医学院附属医院临桂院区普通外科,广西临桂541100

出　　处：《华夏医学》2012年第2期158-161,共4页Acta Medicinae Sinica

基　　金：广西自然科学基金资助项目(2010GXNSFB013088)

摘　　要：目的:探讨64层螺旋CT灌注成像(CT perfusion imaging,CTPI)在肝细胞癌(HCC)诊断中的价值。方法:对18例肝占位共23个病灶行CTPI,获取肝血流量(HBF)、肝血容量(HBV)、肝动脉灌注分数(HAF)、平均通过时间(MTT)以及血管表面通透性(PS)等灌注参数,对比病灶与非病灶区的灌注参数。HCC患者同时测定血清AFP值,并与相应病灶的灌注参数作直线相关分析。结果:本组病灶中18/23个为HCC,4/23个为肝血管瘤,另1病灶为肝局灶性结节增生(FNH)。HCC组18个病灶与非病灶区的灌注参数比较,病灶的HAF增大,MTT及PS减小,差异有统计学意义,其中以HAF的差异最为显著(前者是后者的4.11倍)。血清AFP与HCC病灶的灌注参数值无相关性。肝血管瘤组各灌注参数的改变与HCC类似,但前者病灶区的HBF显著大于HCC。FNH与非结节区的灌注参数均无明显差异。结论:CTPI在HCC的诊断及鉴别诊断中具有重要的参考价值。Objective：To investigate the value of 64-slice spiral CT perfusion imaging （CTPI） in the diagnosis of hepatocellular carcinoma （HCC）. Methods：CTPI was carried out in 18 patients with 23 lesions to obtain the following perfusion parameters：hepatic blood flow （HBF）, hepatic blood volume （HBV）, hepatic arterial fraction （HAF）, mean transit time （MTT） and permeability surface （PS）. All the parameters of lesion and non-lesion areas were compared with each other. In addition, serum AFP of patients with HCC were measured, and a liner correction analysis between AFP level and the CTPI parameters was performed. Results： 18 lesions in this group was HCC, 4 lesions was hepatic hemangioma, another one was hepatic focal nodular hyperplasia （FNH）. Comparing the HCC parameters in 18 lesions with those of the non-lesions, it found out that HAF of lesions enlarged and MTT and PS reduced, which was of statistical difference. Of which, HAF was the significantly different, which was 4. 11 times higher than that of the non-lesion. On the other hand,the correlation between serum AFP level and CTPI parameters of HCC was insignificant. HBF of hepatic hemangioma was significantly higher than HCC. There was no significant difference between the parameters of FNH and non-nodule. Conclusion： CTPI has important reference value in the diagnosis and differential diagnosis of HCC.

关 键 词：体层摄影术 X线计算机 CT灌注成像 肝细胞癌 诊断 

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]