64排螺旋CT灌注成像在原发性肝细胞癌患者诊断中的应用价值  

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

作　　者：杨首香[1] 徐锐[1] 李建龙[1] 王瑞敏[1] 王雁冰[1] 

机构地区：[1]山东省日照市人民医院医学影像科,276826

出　　处：《中华消化病与影像杂志（电子版）》2012年第4期24-28,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的探讨64排螺旋CT灌注成像在原发性肝细胞癌(HCC患者)诊断中的应用价值。方法 30例结节型及巨块型原发性HCC患者(HCC组)分别行全肝常规平扫及灌注扫描,计算肝血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)、肝动脉灌注指数(HAF)等,并与15名健康志愿者(健康对照组)进行比较。结果 HCC组患者癌灶中心BF、HAF均明显高于健康对照组肝组织[(332.51±98.59)ml/(min·100 g)vs(132.58±36.23)ml/(min·100 g),(0.69±0.25)vs(0.22±0.12)],MTT和PS均低于健康对照组肝组织[(8.61±1.96)s vs(16.96±7.0)s,(31.26±16.67)ml/(min·100 g)vs(56.85±14.25)ml/(min·100 g)],且差异均有统计学意义(H值分别为27.80、23.90、15.21,P均<0.017;t=5.09,P<0.01),而BV差异无统计学意义;HCC组患者癌旁组织HAF高于健康对照组肝组织[(0.39±0.23)vs(0.22±0.12)],MTT、PS均低于健康对照组肝组织[(11.28±5.48)s vs(16.96±7.0)s,(34.76±18.05)ml/(min·100 g)vs(56.85±14.25)ml/(min·100 g)],且差异均有统计学意义(H值分别为6.04、6.15,P均<0.017;t=4.13,P<0.01),而BF、BV差异无统计学意义;HCC组癌灶中心与癌旁组织比较,癌灶中心BF、HAF均明显高于癌旁组织[(332.51±98.59)ml/(min·100 g)vs(158.85±108.45)ml/(min·100 g),(0.69±0.25)vs(0.39±0.23)],且差异均有统计学意义(H值分别为28.17、18.20,P均<0.017),而MTT、BV、PS差异无统计学意义。结论 CT灌注成像肝血流灌注参数HBF、HAF、MTT、PS在正常肝组织和HCC组织之间存在明显差异,对HCC病灶的显示与鉴别诊断有重要的临床价值。Objective To obtain the perfusion parameters of normal livers, hepatocellular carcinoma （HCC） and peritumour livers with 64-slice spiral CT and to investigate their characteristics and clinical significances. Methods Using 64-slice spiral CT, all CT plain scan and perfusion scan were performed in 15 volunteers with normal liver and 30 patients with HCC. Using deconvolution through Infusion Software analysis, hepatic blood flow （ BF）, blood volume （ BV ）, the mean transit time （ MTT）, permeability surface （ PS）, hepatic arterial fraction （HAF）, were eaculated, to evaluate normal liver and HCC embolization hemodynamic status. Results The values of BF and HAF of HCCs were significantly higher than those of the normal livers [ （332.51 ±98.59） ml/（min· 100 g） vs （132.58 ± 36.23） ml/（min· 100 g） ,H = 27. 80,P 〈 0. 017; （0.69 ±0.25） vs （0.22 ±0. 12） ,H =23.90,P 〈0. 017], and the MTF and PS of HCCs were significant lower than those of the normal livers [ （ 8.61 ± 1.96 ） s vs （ 16.96 ± 7.0） s,H = 15.21, P 〈 0. 017 ; （ 31.26 ± 16.67 ） ml/（min· 100 g） vs （ 56. 85 ± 14. 25 ） m]/（ min· 100 g）, t = 5.09, P 〈 0. 01 ]. No statistically significant difference was found in BV. The increase of HAF and decrease of MTF, PS of peritumor livers were both significant compared with those of the normal livers （ [ （ 0. 39 ± 0. 23 ） vs （ 0. 22 ± 0. 12 ）, （ 11.28 ± 5.48 ） s vs （16.96±7.0）s,（34.76±18.05） ml/（min ~ 100g） vs （56.85 ± 14.25）ml/（min· 100 g）,H=6.04,6. 15,both P 〈 0.017 ,t = 4. 13 ,P 〈 0. 017 ]. No statistically significant difference was found in BF and BV. The values of BF and HAF of HCCs were significantly higher than those of peritumor livers [ （332.51 ±98.59）ml/（min· 100 g） vs （158.85 ±108.45） ml/（min· 100 g） ,H =28. 17,P 〈0. 017; （0. 69 ±0. 25） vs （0. 39 ±0. 23） ,H = 18.20, P 〈 0. 0171, No statistically significant difference was found in MTT, BV and PS. Con

关 键 词：体层摄影术 螺旋计算机 灌注成像 癌 肝细胞 诊断 

分 类 号：R735.7[医药卫生—肿瘤]