CT平均动脉增强分数彩图在肝细胞型肝癌中的诊断价值  

The value of CT mean arterial enhancement fraction color maps in the diagnosis of hepatocellular carcinoma

作　　者：姜梅[1] 高德宏[1] 张凯[1] 张大波[1] 明建中[2] JIANG Mei;GAO Dehong;ZHANG Kai;ZHANG Dabo;MING Jianzhong(Department of Radiology,Shenzhen Nanshan People's Hospital,Shenzhen 518000;Department of Interventional,Shenzhen Nanshan People's Hospital,Shenzhen 518000)

机构地区：[1]深圳市南山区人民医院影像科,广东深圳518000 [2]深圳市南山区人民医院介入科,广东深圳518000

出　　处：《实用放射学杂志》2020年第4期583-587,共5页Journal of Practical Radiology

基　　金：广东省医学科研基金项目(A2017576).

摘　　要：目的评估CT平均动脉增强分数(AEF)彩图对肝细胞型肝癌(HCC)结节灶的检出能力.方法64例HCC患者106处病灶进行MSCT增强检查,再利用西门子专用分析软件获得全肝的AEF彩图及AEF值.由2位放射学医师进行独立评定,按结节存在可信度以四点法评分,将可疑病变标注在图像上.应用JAFROC性能系数评价检出能力,对其敏感性及特异性进行评价.结果64例患者106处病变平均AEF值为(79±17)%,较正常肝实质AEF值增高(11±6)%,P=0.032,医生对HCC诊断AUC,单纯CT诊断的0.704上升到0.896(医生1),从0.718上升到0.917(医生2)(P<0.05),尤其是直径<1 cm病变尤为显著,AUC从0.739上升到0.905(医生1)和从0.793上升到0.921(医师2)(P<0.01).结论AEF定量彩图能反映HCC的血流灌注特点,CT扫描联合AEF定量彩图对HCC病灶结节有较高的敏感性.Objective To evaluate the ability of CT mean arterial enhancement fraction(AEF)color maps in detecting the nodules of hepatocellular carcinoma(HCC).Methods MSCT enhanced examination was performed in 106 lesions of 64 patients with HCC.And the AEF color maps and AEF values of the whole liver were obtained by using Siemens special analysis software.After two radiologists independently assessed,the score was obtained according the reliability of presence of nodules using four-point method and the suspicious lesions were labeled on the image.JAFROC performance coefficient was used to evaluate detection ability,meanwhile,the sensitivity and specificity were also appraised.Results The mean AEF of 106 lesions of 64 patients was(79±17)%,which was(11±6)% higher than that of liver parenchyma(P=0.032).The AUC increased when multiphasic CT images were combined with AEF color map analysis as compared with evaluation based only on multiphasic CT images(from 0.704 to 0.896 for reader 1,and from 0.718 to 0.917 for reader 2)(P<0.05).The increase AUC was especially significant for lesions less than 1 cm(from 0.739 to 0.905 for reader 1,and from 0.793 to 0.921 for reader 2)(P<0.01).Conclusion AEF quantitative color maps can reflect the blood perfusion characteristics of HCC lesions,it has high sensitivity for HCC nodules when combined with CT.

关 键 词：肝细胞型肝癌 平均动脉增强分数 计算机体层成像 

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