512层螺旋CT灌注成像诊断肝脏结节的价值评价  

Clinical Valueof 512-slice Spiral CT Perfusion Imaging in Diagnosis of Hepatic Nodules

作　　者：廖忠剑[1] 刘小华 王肇平[1] 钟贻洪[1] 杨宏[1] LIAO Zhongjian;LIU Xiaohua;WANG Zhaoping;ZHANG Yihong;YANG Hong(Ganzhou People's Hospital,Ganzhou 341000,China)

机构地区：[1]赣州市人民医院

出　　处：《现代医院》2019年第11期1700-1702,共3页Modern Hospitals

基　　金：江西省卫生计生委科技计划项目(20187261)

摘　　要：目的对肝脏结节应用512层螺旋CT灌注成像诊断的临床价值进行探析,以便为临床诊治提供可靠性依据。方法将2018年2月—2019年4月诊治的45例肝脏结节病变患者纳入研究,均先后行增强CT扫描、512层螺旋CT灌注成像检查,以病理活检结果为标准,分析和总结诊断结果。结果本组45例患者经病理学活检确诊,25例肝硬化结节,20例小肝癌病灶,增强CT的病灶检出率分别为92.0%、80.0%,螺旋CT灌注成像病灶检出率分别为100.0%、95.0%,小肝癌病灶检出率差异有统计学意义(P<0.05),而肝硬化结节无明显差异(P>0.05);通过检测,小肝癌病灶的血流量(BF)、血容量(BV)及肝动脉分数(HAF)均高于肝硬化结节(P<0.01),而血管表面渗透面积(PS)、对比剂通过时间(MTT)及对比剂达峰时间(TTP)无统计学差异(P<0.05)。结论512层螺旋CT增强扫描和灌注成像在肝硬化结节中均有较高检出率,有着重要诊断价值,但后者在肝癌小病灶诊断中符合率高,同时肝脏BF、BV及HAF灌注指标可作为鉴别诊断重要依据。Objective To explore the clinical value of 512-slice spiral CT perfusion imaging in diagnosing hepatic nodules so as to render reliable analysis for clinical diagnosis and treatment.Methods A total of 45 patients with liver nodules admitted from February 2018 to April 2019 underwent enhanced CT scan first and 512-slice spiral CT perfusion imaging later.The diagnoses were analyzed and summarized based on the pathological biopsy results.Results Among 45 patients,25 were diagnosed with nodular cirrhosis and 20 with lesions of small hepatocellular carcinoma.The detection rates of lesion by enhanced CT were 92.0%and 80.0%respectively for the two conditions,while those by spiral CT perfusion imaging were 100.0%and 95.0%,respectively.The difference in detection rate of small liver cancer lesion was statistically significant(P<0.05).However,no significant difference was found in cirrhotic nodules(P>0.05).Through examination,blood flow(BF),blood volume(BV)and hepatic artery fraction(HAF)of small liver cancer lesions were all higher than those of cirrhosis nodules(P<0.01),but there were no statistical differences in permeability surface area(PS),mean transit time(MTT)of contrast agent and its transit time to the peak(TTP)(P<0.05).Conclusion 512-slice enhanced spiral CT scan and perfusion imaging guarantee high detection rate in cirrhosis nodules,thereby enjoying important diagnostic value.Moreover,the coincidence rate by perfusion imagingis relatively high in the diagnosis of small liver cancer lesions,in which perfusion indexes of liver BF,BV and HAF sustain differential diagnosis.

关 键 词：512层螺旋CT 肝硬化结节 灌注成像 诊断 

分 类 号：R814.43[医药卫生—影像医学与核医学] R575.2[医药卫生—放射医学]