双源CT灌注成像在肝转移瘤中的临床应用

发布时间：2019-03-08 17:44

【摘要】：目的:探讨双源CT灌注成像在肝转移瘤诊断及治疗中的临床应用价值。方法:应用双源CT行全肝CT灌注检查,获得血流量(BF)、血容量(BV)、达峰时间(TTP)、肝动脉灌注量(ALP)、门静脉灌注量(PVP)、肝动脉灌注指数(HPI)等灌注参数及灌注伪彩图像,并进行相应统计学分析。结果:(1)肝转移瘤肝动脉灌注量及动脉灌注指数较周围肝实质均升高,而门静脉灌注量则降低,达峰时间明显缩短。(2)肝转移瘤TDC(时间密度曲线)变化较大,但均表现出比较明显上升坡度,峰值出现时间较早。(3)富血供与乏血供转移瘤灌注图有一定差异,在ALP及HPI伪彩图上,病灶外周皆呈高灌注表现,乏血供转移瘤中心多呈低灌注,富血供转移瘤中心不均匀高灌注,周围肝实质呈略低灌注;在PVP图像上,癌灶呈低灌注,周围肝实质呈高灌注。(4)HPI和ALP灌注伪彩图像中显示的病灶面积较CT增强图像面积更大。结论:双源CT灌注可反映肝转移瘤血供情况,对肿瘤真实大小的评估、转移瘤术前指导及术后效果评价具有重要意义。
[Abstract]:Objective: to evaluate the clinical value of dual-source CT perfusion imaging in the diagnosis and treatment of hepatic metastasis. Methods: the whole liver CT perfusion was performed with dual-source CT. The blood flow (BF), blood volume, (BV), peak time, (TTP), hepatic artery perfusion volume, (ALP), portal vein perfusion volume (PVP), were obtained. The perfusion parameters such as hepatic artery perfusion index (HPI) and perfusions were analyzed statistically. Results: (1) the arterial perfusion volume and arterial perfusion index of hepatic metastases were higher than those of the surrounding liver parenchyma, while the portal vein perfusion decreased and the peak time was shortened. (2) the TDC (time density curve) of hepatic metastatic tumors was significantly changed, while the hepatic arterial perfusion volume and arterial perfusion index were higher than those of the surrounding liver parenchyma. (3) the perfusion images of metastatic tumors were different between the rich blood supply and the lack of blood supply. On the ALP and HPI pseudo-color images, the periphery of the lesion showed high perfusion, and the peak value appeared earlier. (3) there was a certain difference in the perfusion pattern between the rich blood supply and the lack of blood supply in the peripheral part of the lesion. There were low perfusion in the center of the metastatic tumor with low blood supply, uneven and high perfusion in the center of the metastatic tumor with rich blood supply, and slightly lower perfusion in the surrounding liver parenchyma. On the PVP images, the tumor focus showed low perfusion and the surrounding liver parenchyma showed high perfusion. (4) the lesion area in HPI and ALP perfusions was larger than that in CT enhanced images. Conclusion: dual-source CT perfusion can reflect the blood supply of hepatic metastatic tumor, and it is of great significance to evaluate the true size of the tumor, preoperative guidance and postoperative evaluation of the metastatic tumor.
【作者单位】：滨州医学院附属医院;
【分类号】：R735.7

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