肝细胞癌多层螺旋CT灌注成像肝血流变化定量研究

目的 应用多层螺旋CT（MSCT）灌注成像技术研究肝细胞癌（HCC）血流灌注参数变化。方法 HCC患者30例，其中手术切除6例，穿刺活检证实4例，其余为临床综合诊断。正常对照组30例。所有对象均依次行常规全肝平扫、CT灌注扫描及常规全肝增强扫描。高压注射器注射非离子型对比剂50ml，流率4.0ml/s，曝光时间50s，采用去卷积模型，通过灌注参数图获得多种灌注参数。结果 肝癌组灌注参数HBF、HBV、HPP降低与癌旁肝组织和正常肝脏相比有统计学差异（P〈0.05）。肝癌组HAP、HAI明显升高，与癌旁肝组织和正常肝组织相比有显著差异（P〈0.01），各灌注参数在癌旁和正常肝组织中无显著差异（P〉0.05）。结论 多层螺旋CT灌注成像能定量反映HCC的肝动脉和门静脉血流灌注信息。

Quantitative study of hepatic dynamic flow in hepatocellular carcinoma by multi-slice CT perfusion

Objective To study the changes of perfusion parameters in hepatocellular carcinoma (HCC) by multi-slice computed tomography (MSCT) perfusion technique. Methods Perfusion CT images were obtained in 30 patients with HCC and 30 control subjects. A single-slice dynamic CT was performed after an intravenous bolus injection of 50 ml of contrast material and continued for 50 seconds at a speed of 4.0 ml/s. The parameters were calculated by deconvolution method, and perfusion maps and quantitative parameters were created. Results For HCC, the decreased parameters such as HBF, HBV, HPP and the increased parameters such as HAP, HAI in HCC were differentiated from the apparently normal liver adjacent to cancer and the normal liver region (P<0.05). All the parameters between the normal liver adjacent to cancer and normal liver region have no differences (P>0.05). Conclusion Perfusion CT can provide quantitative information about arterial and portal blood flow of HCC.