双能量CT碘图强化值与肝细胞癌血管生成的相关性研究  

Correlation between enhancement value measured on iodine mapping of dual-energy CT and angiogenesis in hepatocarcinoma

作　　者：张晓东[1] 季倩[1] 程悦[1] 黄黎香[1] 范文骏[1] 沈文[1] 

机构地区：[1]天津市第一中心医院放射科,天津300192

出　　处：《实用放射学杂志》2014年第2期237-240,274,共5页Journal of Practical Radiology

基　　金：天津市卫生局面上项目（2010KY05）.

摘　　要：目的 探讨双源CT碘图强化值与肝细胞癌形成过程不同阶段结节血管生成的相关性.方法 选择本院2010-08-2012-06临床拟诊为肝细胞癌而需行肝移植术的受体26例纳入研究.术前行双源CT扫描,测量肝硬化相关结节的动脉期碘图强化值;术后测量其血管内皮生长因子（VEGF）免疫反应积分值及微血管密度（MVD）.分析不同病理类型结节动脉期双能量碘图强化值与病理定量指标的关系.结果 将所得44个结节按照病理性质分为3组：再生结节（regenerative nodule,RN） 11个,不典型增生结节（dysplastic nodule,DN）10个,肝细胞癌（hepatocellular carcinoma,HCC） 23个.①3组动脉期碘图强化值的差异有统计学意义（F=4.031,P＜0.001）,HCC组碘图强化值分别与RN及DN组差异有统计学意义（P＜0.05）,而RN组及DN组之间差异无统计学意义（P＞0.05）.②MVD与动脉期碘图强化值呈正相关（r=0.545,P＜0.001）.③VEGF免疫反应积分与动脉期碘图强化值呈正相关（r=0.405,P＜0.05）.结论 双源CT动脉期双能量碘图强化值与MVD和VEGF免疫反应积分之间具有正相关性,能够定量反映肝细胞癌形成中的血管生成状态.Objective To explore the correlation between enhancement value measured on dual-energy CT iodine mapping and angiogenesis during the development of hepatocellular carcinoma （HCC）.Methods The study included 26 receptors of liver transplantation diagnosed as hepatocellular carcinoma in our hospital from August 2010 to June 2012.All the patients underwent dual-energy CT examination before surgery,and the enhancement value of hepatic nodules were measured on iodine mapping of the arterial phase.The immunoreactive score of VEGF and MVD of the nodules were measured after the surgery.The correlation between the enhancement value and the pathological indexes were analysed for the different pathological nodules.Results According to the pathological features,44 nodules were classified into 3 groups：11 regenerative nodules （RNs）,10 dysplastic nodules （DNs）,and 23 HCCs.①The difference of the enhancement values was statistically significant among the three groups（F=4.031,P＜0.001）.The difference between HCC and RN groups,HCC and DN groups were statistically significant （P＜0.05）,while the difference between RN and DN groups was not statistically significant （P＞0.05）.②A positive correlation between MVDs and the enhancement values was found（r=0.545,P＜0.001）.③A positive correlation between the immunoreactive score of VEGF and the enhancement value was found（r=0.405,P＜0.05）.Conclusion The enhancement value on the iodine mapping of the arterial phase performed by dualenergy CT shows the positive correlations with MVD and the immunoreactive score of VEGF.Iodine mapping of dual-energy CT can quantitatively evaluate the angiogenesis during the development of HCC.

关 键 词：双能量CT 碘图 肝细胞癌 血管生成 

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]