320排容积CT全肝灌注成像评价小肝癌血供的临床价值

发布时间：2019-01-30 16:36

【摘要】：目的评价320排螺旋CT灌注成像对小肝癌的血供及临床诊断价值。方法收集2012-04-12-2014-04-12惠山区人民医院住院治疗并经手术或活检确诊的20例小肝癌患者(小肝癌组)及20名正常志愿者(对照组)行320排容积CT全肝灌注成像,另设瘤外正常肝组织组(距癌组织≥2cm),采用最大斜率法计算小肝癌组、瘤外肝组织及对照组的肝动脉血流灌注量(hepatic arterial flow,HAF)、门静脉血流灌注量(hepatic portal flow,HPF)和灌注指数(perfusion index,PI),比较各组间各灌注参数值的差异,评价小肝癌血流动力学改变;并通过色阶赋值形成感兴趣区(region of interest,ROI)灌注参数图,通过与肝脏增强扫描比较,评价灌注扫描诊断小肝癌的价值。结果小肝癌组的HAF(mL·min-1·mL-1)值为(137.1±13.9),明显高于瘤外正常肝组织组的(53.6±20.7),差异有统计学意义,t=1.794,P0.05;也明显高于正常对照组的(55.8±16.1),差异有统计学意义,t=-0.089,P0.05。小肝癌组的HPF(mL·min-1·mL-1)值为(90.1±33.6),明显低于瘤外正常肝组织组的(237.4±20.9)差异有统计学意义,t=-1.834,P0.05;也明显低于正常对照组的(232.0±29.3),差异有统计学意义,t=0.514,P0.05。小肝癌组的PI率为(60.0±9.5)%,明显高于瘤外正常肝组织组的(17.8±4.9)%,差异有统计学意义,t=2.132,P0.05;也明显高于正常对照组的(19.1±4.3)%,差异有统计学意义,t=-0.157,P0.05。瘤外肝组织HAF和PI明显高于正常对照组,HPF低于对照组,表现出与小肝癌相似的血供特点。320排CT全肝灌注扫描对小肝癌的确诊率为80.0%(16/20),传统三期增强扫描对小肝癌的确诊率为30.0%(6/20),灌注扫描与三期增强扫描诊断小肝癌的准确率明显高于传统三期增强扫描,P0.05。结论 320排容积CT全肝灌注成像能有效地评价小肝癌血供情况,全肝灌注扫描较常规三期增强扫描对小肝癌的诊断准确率明显提高,对小肝癌的早期诊断具有重要价值。
[Abstract]:Objective to evaluate the value of 320-slice spiral CT perfusion imaging in blood supply and clinical diagnosis of small hepatocellular carcinoma. Methods Twenty patients with small liver cancer (small liver cancer group) and 20 normal volunteers (control group) who were hospitalized in Huishan people's Hospital 2012-04-12-2014-04-12 and confirmed by operation or biopsy were studied. In addition, the normal liver tissue (鈮，

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