CT灌注成像在肝脏局限性结节状增生和肝细胞肝癌鉴别诊断中的价值  

Differential diagnosis value of CT perfusion imaging in hepatic focal nodular hyperplasia and hepatocellular carcinoma

作　　者：姜正岳 马振波[2] 孔兰玉 朱莉[4] 谢元忠[2] 

机构地区：[1]肥城市中医院磁共振室,山东省271600 [2]泰安市中心医院医学影像科,山东省271000 [3]肥城市中医院内科,山东省271600 [4]泰山医学院附属医院输血科,山东泰安271000

出　　处：《中华消化病与影像杂志（电子版）》2015年第2期13-16,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的探讨CT灌注成像在肝脏局限性结节状增生(FNH)和肝细胞肝癌(HCC)鉴别诊断中的价值。方法回顾性分析经手术或穿刺活检病理证实的9例FNH和12例HCC的CT灌注成像参数,对每组病例的血容量(BV)、血流量(BF)、门静脉灌注量(PVP)、肝动脉灌注量(ALP)及肝动脉灌注指数(HPI)共5个灌注指标进行分析。比较9例FNH和12例HCC的实性成分及每组实性成分与周围正常肝脏组织的CT灌注参数。结果 FNH组及HCC组中病灶实性部分的BV、BF、ALP、HPI均高于远处肝组织,PVP均低于远处肝组织,且存在统计学差异。FNH组的实性部分血容量(BV)、血流量(BF)、肝动脉灌注量(ALP)及肝动脉灌注指数(HPI)都高于HCC组,门静脉灌注量(PVP)低于HCC组,以上数据存在统计学差异。结论 CT灌注成像能反映FNH和HCC的血流灌注特点,对FNH与HCC的诊断及鉴别诊断具有重要临床意义。Objective To investigate the differential diagnosis value of CT perfusion imaging in hepatic focal nodular hyperplasia（FNH）and hepatocellular carcinoma（HCC）.Methods Nine cases with FNH and twelve cases with HCC confirmed by operation or aspiration biopsy were retrospectively analyzed by CT perfusion imaging parameters.A total of five perfusion indexes including blood volume（BV）,blood flow （ BF） ,portal venous perfusion （ PVP ） , hepatic artery perfusion （ ALP ） and hepatic artery perfusion index （ HPI） were analyzed in each group.The comparisons were made between the solid parts of nine cases with FNH and twelve cases with HCC and surrounding normal liver tissue in each group.Results The BV,BF, ALP and HPI of the focal solid parts in both FNH group and HCC group were higher than thoes in distant liver tissue,otherwise the PVP was lower,and the differences were statistically significant.The BV,BF,ALP and HPI of the solid parts in FNH group were higher than those in HCC group,but the PVP was lower,and the differences were statistically significant.Conclusions CT perfusion imaging can reflect the blood perfusion characteristics of FNH and HCC.Thus,there is important clinical significance for the diagnosis and differential diagnosis of FNH and HCC.

关 键 词：局限性结节状增生 肝细胞癌 X线计算机 灌注 

分 类 号：R735.7[医药卫生—肿瘤]