摘要
目的 探讨DSCT灌注(DSCTP)对 肝细胞癌、肝血管瘤及FNH的诊断意义。 方法 通过对10例原发性肝细胞癌、8例 肝血管瘤及8例FNH的病灶实性部分、边 缘部分以及正常肝实质的CT灌注参数分 析,研究各组病灶实质部分的参数。结 果 BF、BV、HAP值在肝细胞癌、血管瘤 及FNH三组中均较正常肝实质增高:其中 BF、BV由高至低依次为FNH、肝细胞癌、 血管瘤(P<0.05),HAP在肝细胞癌、血管 瘤间无显著差异(P>0.05),但明显低于 FNH(P<0.01);TTS及TTP在肝细胞癌组及 FNH组低于正常肝实质,在血管瘤组则高 于正常肝实质,由高至低依次为血管瘤、 肝细胞癌、FNH(P<0.05);PS值在肝细胞 组及FNH组中高于正常肝实质(P<0.05), 血管瘤组则与正常肝实质无明显差异(P> 0.05),由高至低依次为FNH、肝细胞癌、 血管瘤(P<0.05)。结论 DSCT灌注参数反 映出肝细胞癌、血管瘤及FNH肿瘤结节的 血供类型与分布特点,具有鉴别诊断的临 床价值。
Objective To investigate the dual-source CT perfusion imaging(CTPI) features of hepatocellular carcinoma(HCC), hepatic hemangioma and Focal nodular hyperplasia(FNH) and its diagnose value. Methods CT perfusion scans were performed with dual-source CT in 10 HCC patients, 8 hepatic hemangioma patients and 8 FNH patients, perfusion parameter of center and edge of lesions, normal liver tissue were collected and analyzed. Results The values of blood flow(BF), blood volume (BV), Hepatic arterial perfusion(HAP)were higher than normal liver tissue in HCC group, hepatic hemangioma group and FNH group(P<0.05), The values of BF, BV was the highest for FNH group, followed by HCC group, hepatic hemangioma group(P<0.05), There were no statistical differences between the values of BF, BV in HCC group and hepatic hemangioma group(P>0.05), but both significantly lower than FNH group(P <0.01). The values of time to start(TTS), time to peak(TTP) were significantly lower than normal liver tissue in HCC group and FNH group(P<0.05), but significantly higher than normal liver tissue in hepatic hemangioma group, the values of TTS, TTP was the highest for hepatic hemangioma group, followed by HCC group, FNH group(P<0.05). The values of permeability of surface area product(PS) were higher than normal liver tissue in HCC group and FNH group, but were no statistical differences in hepatic hemangioma group(P>0.05), the values of PS was the highest for FNH group, followed by HCC group, hepatic hemangioma group(P<0.05). Conclusion Dual-source CTPI can provide much more information about the hemodynamics, blood supply and distribution features of HCC, hepatic hemangioma and FNH, which is helpful in differential diagnosing and clinical value.
【关键词】双源CT灌注成像;原发性肝 癌;肝血管瘤;FNH
【中图分类号】R735.7
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.12.023
前言
CT灌注成像(CTPI)技术提出至今将20余年[1],随着多排CT的普 及,灌注成像越来越多地应用于肝脏疾病评价中[2-4]。肝细胞癌、肝血 管瘤及局灶性结节性增生(FNH)为肝脏最常见的富血供病变,部分病例 增强三期扫描仍难于鉴别。本文回顾性研究本院2013年2月~2015年4 月确诊肝细胞癌、肝血管瘤及FNH病灶的CT灌注影像资料,统计分析病 灶各灌注参数差异,总结肝细胞癌、肝血管瘤及FNHCT灌注成像一般表 现,讨论CT灌注成像在肝富血供占位性病变的诊断价值。
中国CT和MRI杂志
第14卷, 第 12 期
2016年12月
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