全肝CT灌注显像技术对肝隐匿性转移瘤的诊断价值  

Diagnostic value of total hepatic CT perfusion imaging in hepatic occult metastatic tumors

作　　者：杨云飞 

机构地区：[1]北京市密云区医院放射科,北京101500

出　　处：《中国中西医结合消化杂志》2018年第2期155-158,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]探讨全肝CT灌注显像技术对肝隐匿性转移瘤的诊断价值。[方法]对12例存在肝隐匿性转移瘤的患者及15例健康志愿者采用全肝CT灌注技术进行扫描,应用最大斜率法数学模型对扫描图像进行后处理,由此获得灌注参数,包括肝动脉灌注指数(HPI)、肝动脉灌注量(HAP)等。对对照组正常肝脏各肝段灌注参数的差异进行分析,并对正常肝段与存在隐匿性转移肝段灌注参数的差异进行分析。[结果]对照组各肝段HPI及HAP值各段参数值差异无统计学意义,对照组中肝段HPI均值为(19.62±0.56)%,HAP均值为(15.82±0.48)ml·min^(-1)·100g^(-1)。与对照组比较,OHM组肝段HPI及HAP值均明显高于对照组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,HPI及HAP诊断隐匿性转移肝段最佳阈值分别为29.18%、23.97ml·min^(-1)·100g^(-1),前者灵敏度及特异度分别为68%、88%;后者灵敏度及特异度分别为74%、89%。[结论]正常肝脏组织各肝段灌注情况可以通过全肝CT灌注显像技术进行反映,对于情况相近的肝脏各段血流灌注情况全肝CT灌注也可提示。对于存在隐匿性转移肝段,全肝CT灌注可以通过肝段灌注参数值变化来进行反映,因此在隐匿性转移肝段的早期诊断方面可能具有一定的临床价值。[Objective]To explore the diagnostic value of total hepatic CT perfusion imaging in hepatic occult metastatic tumors.[Methods]12 patients diagnosed with＂occult hepatic metastases（OHM）＂and 15 healthy volunteers had accepted the total liver CT perfusion scanning.The data was analyzed with the software of Functional analysis.Maximum slope method for the mathematical model was used in the processing,and hepatic artery perfusion（HAP）and hepatic perfusion index（HPI）of the perfusion pseudo-color pictures were obtained.First,the values of HAP,HPI in S1-S8 had been calculated.Then,the differences by statistical analysis of HAP,HPI of hepatic segments were detected between the control group and patients group.Finally,the best threshold of HAP,HPI for detecting OHM and the corresponding sensitivity and specificity were determined.[Results]Among hepatic segments of the control group,there was no significant statistical difference hepatic in HAP,so as HPI.The mean of HAP was（15.82±0.48）ml·min^（-1）·100 g^（-1） and the mean of HPI Was（19.62±0.56）% .The HAP,HPI of hepatic segments with OHM were higher than the control group and there was significant difference（P0.05）.By analysis of ROC Curve,the best threshold of HAP to detect OHM was 23.97 ml·min^（-1）·l00 g^（-1） with the sensitivity of 74% and specificity 89% .The best threshold of HPI was 29.18% with the sensitivity of 68% and specificity 88% .[Conclusion]The total liver perfusion CT can accurately reflect the normal liver tissue perfusion of the hepatic segments,and prompts the parameters among each segment are similar.Peffusion parameters can re-flect the changes in blood flow of liver segment with OHM,and thus early diagnosis of OHM can be made.So there may be some clinical value in the early diagnosis of occult metastases.

关 键 词：肝隐匿性转移 肝转移瘤 肝脏灌注成像 体层摄影术 

分 类 号：R735.7[医药卫生—肿瘤]