64排螺旋CT三期增强扫描测定肝血管瘤容积价值分析*

目的 探讨使用64排螺旋CT三期增强扫描测定肝血管瘤(HH)容积的价值。方法 2020年6月～2021年3月我院诊治的HH患者88例,接受64层螺旋CT进行三期动态增强扫描,经后处理系统,测定瘤体容积和增强容积,计算动脉期强化比率,分析螺旋CT三期增强扫描检查的意义。结果 在88例HH患者中,CT平扫检出122个病灶,其中单发病灶54例(61.4%),多发病灶34例(38.6%);肝右叶95例(77.9%),肝左叶27例(22.1%);病灶呈圆形或类圆形100个(82.0%),边界清楚,不规则22个(18.0%);病灶直径为2～10 cm者87个(71.3%),>10 cm者35个(28.7%);CT平扫显示111个(91.0%)为低密度灶,7个(5.7%)为等密度灶,4个(3.3%)为高密度灶;增强扫描动脉期122个病灶中有102个(83.6%)存在边缘结节状或斑块状强化,其中轻度强化灶25例(24.5%),中等强化灶37例(36.3%),明显强化灶40例(39.2%);门脉期122个病灶中有98个(80.3%)存在造影剂向病灶内部填充,密度逐渐下降,另24个(19.7%)病灶未观察到增强;在增强扫描后经3D后处理,发现直径大于10 cm的HH病灶瘤体容积和强化容积分别为(370.1±52.8)cm³和(50.7±10.9)cm³,均显著大于【分别为(118.8±24.6)cm³和(42.3±10.6)cm³,P<0.05】,而动脉期强化比率为(13.7±4.3)%,显著小于直径≤10 cm的HH【(35.6±10.2)%,P＜0.05】。结论 使用64排螺旋CT三期增强扫描可明确肝血管瘤的形态、大小和密度,测定HH动脉期强化比率可准确地反映病变的血供特征。

Hepatic hemangioma volume measurement by three-phase enhancement scan of 64-slice spiral CT

Objective The aim of this study was to summarize the value of three-phase enhancement scan of 64-slice spiral CT in measuring hepatic hemangioma (HH) volume. Methods 88 patients with HH were enrolled in our hospital between June 2020 and March 2021, and all underwent 64-slice spiral CT three-phase enhancement scan. The enhancement volumes in different phases were detected and measured. Results Out of the 88 patients with HH, the CT plain scan showed that there were 122 lesions, including 54 cases (61.4%) with single lesions and 34 cases (38.6%) with multiple lesions; there were 95 lesions (77.9%) in the right lobe of livers and 27 lesions (22.1%) in the left lobe; there were 100 (82.0%) round or quasi-circular lesions, with clear boundaries, and 22 (18.0%) irregular lesions; there were 87 (71.3%) lesions with diameters of 2 to 10 cm and 35 (28.7%) lesions greater than 10 cm; the CT plain scan showed that there were 111 (91.0%) low-density, 7 (5.7%) iso-density and 4 (3.3%) high-density lesions; the enhancement scan showed that there were 102 (83.6%) lesions with marginal nodular and plaque-like enhancement in arterial phase, including 25 (24.5%) with mild, 37 (36.3%) with moderate and 40 (39.2%) with significant enhancement; in portal phase, there were 98 (80.3%) lesions filled with contrast agents, and the density as gradually decreased, and the other 24 (19.7%) lesions were not accompanied with enhancement; after 3D post-processing, the tumor volume and the arterial enhancement volume in lesions greater than 10 cm were(370.1±52.8)cm³ and (50.7±10.9)cm³, both significantly greater than (118.8±24.6)cm³ and (42.3±10.6)cm³, respectively, P<0.05], while the arterial enhancement ratio of the lesions was (13.7±4.3)%, significantly less than (35.6±10.2)%, P＜0.05] in lesions less than or equal to 10 cm. Conclusion The 64-slice spiral CT three-phase enhancement scan could determine the morphology, size and density of hepatic hemangioma, and the enhancement ratio of hepatic hemangioma in arterial phase could accurately reflect blood supply of the lesions, which might be beneficial to the subsequent intervention treatment.