肝血管瘤CT增强诊断分型与肝固有动脉直径相关性研究  

Correlation between the enhanced CT classification of hepatic hemangiomas and the diameter of proper hepatic artery

作　　者：王娇 贾科峰[1] 于长路[1] 李博[1] WANG Jiao;JIA Kefeng;YU Changlu;LI Bo(Department of Radiology,Tianjin Municipal Third Central Hospital,Tianjin 300170,China)

机构地区：[1]天津市第三中心医院放射科,天津300170

出　　处：《介入放射学杂志》2023年第4期376-380,共5页Journal of Interventional Radiology

摘　　要：目的 探讨不同血供类型血管瘤的CT增强扫描影像学特点,并分析血供分型与肝固有动脉直径的相关性。方法 回顾性分析2019年1月至2021年9月经影像或临床明确诊断为肝海绵状血管瘤的111例患者临床和影像资料。根据病灶动脉期强化特征分为高速灌注(出现中心填充趋势,呈斑片状、片状强化)、中速灌注(填充部分血窦,勾勒部分病灶边缘,表现为结节状、线状强化)和低速灌注(病灶边缘少许血窦填充,呈边缘点状强化)。测量患者肝固有动脉直径、病灶直径,分析血流灌注快慢与肝固有动脉直径、病灶直径的相关性。结果 入组111例病灶中,高速灌注57例,中速灌注18例,低速灌注36例。高速、中速灌注病灶的肝固有动脉直径均大于低速灌注病灶,差异有统计学意义(P<0.05)。中速、高速灌注病灶间肝固有动脉直径差异无统计学意义(P>0.05)。将高速、中速灌注病灶归为富血供,低速灌注病灶归为乏血供,两者间肝固有动脉直径的受试者工作特征曲线(ROC)下面积为0.788,截断值为4.2 mm,灵敏度为77.3%,特异度为75.0%。高速、中速、低速灌注间病灶直径比较,差异无统计学意义(P>0.05)。结论 CT增强扫描可显示肝血管瘤灌注特点,并可用于分析血供类型。肝固有动脉直径是肝血管瘤灌注的影响因素,测量其大小有助于肝血管瘤血供分型。Objective To investigate the imaging characteristics of hepatic hemangiomas with different blood supply types on enhanced CT scan, and to analyze the correlation between the blood supply types and the diameter of proper hepatic artery. Methods The clinical data and imaging materials of 111 patients with hepatic cavernous hemangioma, whose diagnosis was confirmed by imaging or clinical materials between January2019 and September 2021, were retrospectively analyzed. According to the lesion's arterial phase enhancement characteristics, the hepatic hemangiomas were classified into high-speed perfusion group(presenting central filling trend, and patchy, flaky enhancement), medium-speed perfusion group(some sinusoids being filled with contrast, some lesion's edge being outlined, presenting nodular and linear enhancement), and low-speed perfusion group(a few sinuses at lesion 's edge being filled with contrast, presenting as marginal punctate enhancement). The diameters of the lesions were measured, and the relationships of the blood perfusion speed to the diameter of proper hepatic artery and to the diameter of lesion were analyzed. Results Among the111 lesions, 57 were in high-speed perfusion group, 18 were in medium-speed perfusion group, and 36 were in low-speed perfusion group. The diameter of the proper hepatic artery in the high-speed perfusion group and medium-speed perfusion group was significantly larger than that in the low-speed perfusion group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in the diameter of the proper hepatic artery between the high-speed perfusion group and medium-speed group(P>0.05). When the high-speed and medium-speed perfusion lesions were classified as hypervascular hemangiomas, and the lowspeed perfusion lesions were classified as hypovascular hemangiomas, the area under receiver operating characteristic curve(AUC) was 0.788, the optimal cutoff was 4.2 mm, the sensitivity was 77.3%, and the specificity was 75.0%. No stati

关 键 词：肝血管瘤 血供分型 CT增强 肝固有动脉 

分 类 号：R735.7[医药卫生—肿瘤]