基于CT的细胞外容积对非肝硬化背景下肝细胞癌的鉴别诊断价值  

The Value of CT-Based Extracellular Volume in the Differential Diagnosis of Hepatocellular Carcinoma in the Absence of Cirrhosis

作　　者：王泽华 吴英 刘瑶 马静[2] WANG Zehua;WU Ying;LIU Yao(Xinjiang Medical University,Urumqi,Xinjiang Uygur Autonomous Region 830054,P.R.China)

机构地区：[1]新疆医科大学,乌鲁木齐830054 [2]新疆生产建设兵团医院影像科,乌鲁木齐830002 [3]新疆医科大学第一附属医院影像中心,乌鲁木齐830054

出　　处：《临床放射学杂志》2024年第12期2089-2093,共5页Journal of Clinical Radiology

基　　金：肝细胞肝癌微循环构成与活化态肝星状细胞的相关性及MR对微循环的评估价值的研究(编号:81660283);天山英才-青年科技创新人才项目基金资助(编号:2023TSYCCX0119)。

摘　　要：目的 探讨基于CT的细胞外容积对非肝硬化背景下肝细胞癌(HCC)、肝内胆管癌(ICC)及肝转移瘤的鉴别诊断价值。方法 回顾性分析符合纳入与排除标准的113例经病理诊断HCC(49例)、ICC(33例)、肝转移瘤(31例)患者的临床及影像学资料,所有患者检查前均采集红细胞压积,并行CT增强扫描,且CT无肝硬化征象;CT后处理软件测量病灶、病灶周缘1 cm以内肝实质和同层面腹主动脉平扫以及延迟期的CT值,计算细胞外体积分数(fECV)。统计学分析fECV在各组的值及值的高低。结果 HCC组、ICC组、肝转移瘤组的病灶、病灶周缘1 cm以内肝实质fECV值比较差异具有统计学意义(P<0.05);HCC组、ICC组、肝转移瘤组病灶两两对比差异均具有统计学意义;HCC组和肝转移瘤组的病灶与周缘1 cm以内肝实质对比差异具有统计学意义,ICC组病灶与周缘1 cm以内肝实质对比差异无统计学意义;HCC组、ICC组病灶周缘1 cm以内肝实质的fECV值分别与肝转移瘤组对比差异均有统计学意义,HCC组与ICC组病灶周缘肝实质对比差异无统计学意义。结论 基于CT延迟期量化的fECV可有效诊断及鉴别非肝硬化背景下HCC、肝转移瘤及ICC。Objective To investigate the value of CT-based extracellular volume in the differential diagnosis of hepatocellular carcinoma(HCC),intrahepatic cholangiocarcinoma(ICC)and liver metastases.Methods The clinical and imaging data of 113 patients with pathologically diagnosed HCC,ICC,and liver metastases(49 HCC,33 ICC,and 31 liver metastases)who met the inclusion and exclusion criteria from January 2021 to August 2023 in Xinjiang Production and Construction Corps Hospital were retrospectively enrolled.The CT values of the liver parenchyma and the abdominal aorta at the same level within 1 cm of the lesion periphery and the delayed period were calculated.The values of fECV in each group and the level of ECV were statistically analyzed.Results There were statistically significant differences in the fECV values of lesions and liver parenchyma within 1 cm of the periphery of HCC group,ICC group and liver metastases group(P<0.05).There were statistically significant differences in the fECV values of liver parenchyma within 1 cm of the lesion periphery of the ICC group and the liver metastasis group,but there was no significant difference between the HCC group and the ICC group.Conclusion fECV based on CT delay period quantification can effectively diagnose and distinguish hepatocellular carcinoma,liver metastases and intrahepatic cholangiocarcinoma.

关 键 词：肝细胞癌 肝内胆管细胞癌 肝转移瘤 细胞外容积 细胞外体积分数 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学]