应用双源CT增强扫描多参数成像诊断肝硬化背景下肝癌的价值  

Value of applying dual-source CT-enhanced scanning with multiparametric imaging for the diagnosis of hepatocellular carcinoma in the setting of liver cirrhosis

作　　者：袁张强 路志凯[1] 王冠民[1] YUAN Zhang-qiang;LU Zhi-kai;WANG Guan-min(CT Room,General Hospital,Taiyuan Iron and Steel(Group)Co.,LTD.,Taiyuan Shanxi 030008,China)

机构地区：[1]太原钢铁(集团)有限公司总医院CT室,山西太原030008

出　　处：《临床和实验医学杂志》2025年第2期203-206,共4页Journal of Clinical and Experimental Medicine

基　　金：山西省医学重点科研项目(编号:2021XM42);太原钢铁(集团)有限公司科研项目(编号:2021-01)。

摘　　要：目的探究应用双源CT增强扫描多参数成像诊断肝硬化背景下肝癌的价值。方法回顾性选取2022年3月至2024年3月太原钢铁(集团)有限公司总医院收治的103例存在肝内结节的肝硬化患者。以病理检查结果为金标准进行分组,有66例患者诊断为原发性肝癌,纳入肝癌组,其他37例患者均诊断为良性结节,纳入良性结节组。所有患者均应用双源CT扫描及增强灌注扫描。比较肝癌组患者及良性结节组患者各项参数(动脉期和静脉期CT强化值、动静脉期CT净增值、血容量、肝动脉分数、血流量、肝动脉灌注量)差异,并探究其诊断价值。结果肝癌组和良性结节组患者的动脉期、静脉期CT强化值比较,差异均无统计学意义(P>0.05);肝癌组患者的动静脉期CT净增值为(9.23±3.12)HU,低于良性结节组[(12.96±5.19)HU],差异有统计学意义(P<0.05)。肝癌组的血容量、肝动脉分数、血流量、肝动脉灌注量分别为(17.45±5.12)mL/100 g、0.22±0.03、(182.45±15.45)mL/(min·100 g)、(38.45±4.44)mL/(min·100 g),均低于良性结节组[(19.46±3.11)mL/100 g、0.29±0.02、(202.23±16.96)mL/(min·100 g)、(52.36±5.45)mL/(min·100 g)],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,结果可知动静脉期CT净增值、肝动脉分数、血流量、肝动脉灌注量均是影响肝癌发生的重要因素(P<0.05)。经受试者操作特征(ROC)曲线分析,动静脉期CT净增值、肝动脉分数、血流量、肝动脉灌注量均对肝癌具有较高的诊断价值,其曲线下面积(AUC)值分别为0.700、0.971、0.805、0.972。结论双源CT增强扫描多参数成像在诊断肝硬化背景下的肝癌中具有显著价值,在动静脉期CT净增值、血容量、肝动脉分数、血流量和肝动脉灌注量等参数上明显低于良性结节患者,可用作区分肝癌与良性结节的有效工具。Objective To investigate the value of applying dual-source CT enhanced scanning multiparametric imaging to diagnose hepatocellular carcinoma in the context of liver cirrhosis.Methods A total of 103 patients with liver cirrhosis with intrahepatic nodules admitted to General Hospital,Taiyuan Iron and Steel(Group)Co.,LTD.from March 2022 to March 2024 were retrospectively selected.According to the results of pathological examination as the gold standard,66 patients were diagnosed as primary liver cancer and included in the liver cancer group,and the other 37 patients were diagnosed as benign nodules and included in the benign nodule group.All patients underwent dual-source CT scan and enhanced perfusion scan.The differences of various parameters(arterial and venous phase CT enhancement values,arterial and venous phase CT net value-added,blood volume,hepatic artery fraction,blood flow and hepatic artery perfusion)between patients in the liver cancer group and patients in the benign nodules group were compared.Results There were no statistically significant differences in the arterial and venous phase CT enhancement values between patients in the liver cancer group and benign nodule group(P>0.05),the arterial and venous phase CT net value-added of patients in the liver cancer group was(9.23±3.12)HU,which was lower than that of the benign nodule group[(12.96±5.19)HU],and the difference was statistically significant(P<0.05).The blood volume,hepatic artery fraction,blood flow,and hepatic artery perfusion in the liver cancer group were(17.45±5.12)mL/100 g,0.22±0.03,(182.45±15.45)mL/(min·100 g),and(38.45±4.44)mL/(min·100 g),respectively,which were lower than those in the benign nodules group[(19.46±3.11)mL/100 g,0.29±0.02,(202.23±16.96)mL/(mino100 g),(52.36±5.45)mL/(mino100 g)],the differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that the net value of CT,hepatic artery fraction,blood flow and hepatic artery perfusion were all important factors aff

关 键 词：肝硬化 肝肿瘤 诊断 双源CT 增强灌注扫描 

分 类 号：R73[医药卫生—肿瘤]