多层螺旋CT灌注成像在肝脏肿瘤诊断中的应用研究

目的探讨肝脏良恶性肿瘤的CT灌注成像参数,研究其肝血流灌注参数的变化规律,找出诊断依据。方法本组30例行肝脏CT灌注扫描,其中肝血管瘤10例,肝囊肿3例;肝癌12例,正常5例及正常组织25例。应用去卷积算法模式计算相应病变区域的血流量(BF)、血容量(BV)、平均通过时间(MTT)、毛细血管通透性(PS)、肝动脉灌注指数(HPI)、肝动脉灌注量(HAP)和门静脉灌注量(PVP)。根据各灌注图像及相关参数评价正常组织与良恶性肿瘤的血流动力学状态。结果全部受试者均按要求完成检查。12例肝脏恶性肿瘤(肝癌)患者BF、HPI及HAP明显高于正常组(P<0.01),MTT明显降低(P<0.01),均与良性肿瘤组无统计学差异(P>0.05);PS在肝脏恶性肿瘤组、良性肿瘤组及正常组均无明显统计学差异(P>0.05),但肝良性肿瘤组中血管瘤的BV却高于正常组和肝癌组(P<0.05),而正常组与肝癌组的BV无统计学差异(P>0.05)。结论MSCT灌注参数BF、BV、HPI、MTT和HAP能有效的评价肝脏肿瘤的血流状态,在肝脏良恶性肿瘤的鉴别诊断中有重要的临床价值。

Diagnosis study of MSCT perfusion imaging in the liver cancer

Objective To study benign and malignant liver tumors CT perfusion imaging parameters,study the changes in liverperfusion parameters to identify diagnosis.Methods The 30 routine liver CT perfusion scanning,10 cases ofhepatic hemangioma,3 cases of hepatic cysts;12 patients of liver cancer,5 normal patients and 25 cases with normal tissue.Convolution algorithm applied to the calculation of the corresponding regional blood flow(BF),blood volume(BV),mean transit time(MTT),permeability surface(PS),hepatic perfusion index(HPI),hepatic artery perfusion(HAP) and portal venous perfusion(PVP).According to the perfusion parameters,we could evaluate hemodynamics of benign and malignant tumors.Results All the subjects complete the physical examination according to the requirement.BF,HAP,HPI was significantly higher in liver cancer group than the normal control group(P<0.01),but MTT was significantly lower in cancer group than the normal control group(P<0.01),all of the four numerus in cancer group have no significant differences with the benign group(P>0.05).PS in the three groups have no significant differences(P>0.05).BV is higher in benign group than the other two groups(P<0.05),While BV in normal group and liver cancer group have no significant differences(P>0.05).Conclusion BF,BV,HPI,MTT and HAP of MSCT Hepatic perfusion parameters can effectively evaluate blood flow in liver tumors.It has important clinical value in the differential diagnosis of benign and malignant liver tumors.