平板探测器CT和传统CT灌注成像在肝细胞癌血容量评估中比较  

Comparison evaluation of hepatic blood volume in hepatocellular carcinoma between flat detector CT and conventional multislice CT perfusion imaging

作　　者：管逊 庄治国[1] 池嘉昌[1] 王文晶[1] 王嵇[1] 周炜[1] 许建荣[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200127

出　　处：《生物医学工程与临床》2014年第3期236-241,共6页Biomedical Engineering and Clinical Medicine

基　　金：国家自然科学基金资助项目(81201172)

摘　　要：目的探讨运用平板探测器CT灌注成像（FD—CTP）在肝细胞癌（HCC）中评估血容量（BV）的可行性，并与传统CT灌注成像（CTP）进行比较。方法选择20例HCC患者，其中男性13例，女性7例；年龄36—82岁，中位年龄58岁。先后进行传统CTP检查和FD—CTP检查，首先运用CTP测量肿瘤和肝实质区BV值（CTP—BV），再运用FD—CTP测量相对应区的BV值（FD—BV），根据下列等式提取CTP-BV中的动脉灌注产生部分（CTP—BVarterial）：CTP—BVarterial=CTP—BV×HPI（HPI为肝动脉灌注指数）。另外假设：肝肿瘤的CTP-BVarterial／肝实质的CTP-BVarterial=CTP-BVarterial相对值，肝肿瘤的FD—BV／肝实质的FD—BV=FD—BV相对值。分析两种检查BV值的关系。结果CTP-BVarterial和FD—BV绝对值之间有良好的相关性（HCC：r=0．903：肝实质：r=0．920；P〈0．001）。B1and—Altman检验显示，CTP—BVarterial和FD—BV相对值的平均差值为-0．15±0．24。结论HCC或肝实质的FD-BV和CTP-BVarterial值均具有良好的可比性，肝脏FD—CTP检查在临床上具有可行性。Objective To investigate the feasibility of determining blood volume（BV） in hepatoeellular carcinoma（HCC） by using flat detector computed tomography perfusion （FD-CTP）, and compare the measurements between FD-CTP and conventional CT perfusion（CTP）. Methods A total of 20 HCC patients enrolled, included 13 males and 7 females, aged 36 - 82 year old with median age of 58. All of them were given CTP, and then FD-CTP was performed. The BV values of CTP （CTP-BV） and FD-CTP（FD-BV） were measured within tumors and liver parenehyma correspondingly. The arterial perfusion portion of CTP -BV （CTP-BVarterial） was extracted under the assumption of CTP-BVarterial = CTP-BVarterial HPI（HPh represents hepatic perfusion index）. Relative value（RV） for CTP-BVarterial was defined as CTP-BVarterial of tumor / CTP-BVarterial of parenchyma, and RV for FD-BV was defined as FD-BV of tumor / FD-BV of parenehyma. Relationships between BV values of 2 techniques were analyzed. Results There were good correlations between the absolute values of FD-BV and CTP-BVarterial （tumor r = 0.903, parenchyma r = 0.920, both P 〈 0.001）. Bland-Ahman analysis showed mean difference of - 0.15 ± 0.24 between RV for CTP-BVarterial and FD-BV. Conclusion It is demonstrated that FD-BV have good comparability with CTP-BVarterial in both HCC and liver parenchyma, and FD-CTP for liver seems to be feasible in clinical use.

关 键 词：平板探测器 体层摄影术 X线计算机 灌注成像 肝细胞癌 血容量 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]