原发性肝脏肿瘤的CT灌注研究

目的采用多层螺旋CT及肝脏灌注软件进行肝脏原发肿瘤的灌注研究,对比和评价肝癌与肝脏良性高血供肿瘤(HBHT)以及肿瘤与周围肝实质间的CT灌注差别。方法对30例肝癌患者和22例HBHT患者行肝脏多层螺旋CT灌注扫描,并分别测量两组肝脏肿瘤及周围肝实质的CT灌注值,包括血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)、肝动脉分数(HAF)及到达时间,并获得相应的灌注图。结果肝癌病灶的BF、BV及HAF平均值高于周围肝实质(P均为0.000)。HBHT病灶BF和HAF的平均值也高于周围肝实质(P=0.004及0.000)。肝癌及HBHT病灶MTT的平均值均短于相应周围肝实质(P=0.015及0.027),同时肝癌病灶的MTT也短于HBHT病灶(P=0.039)。肝癌病灶及周围肝实质的HAF均高于HBHT病灶及周围肝实质(P=0.036及0.044)。结论肝脏良恶性肿瘤间以及肝脏肿瘤与周围肝组织间存在灌注上差别,可为肿瘤诊断及鉴别诊断提供帮助。

CT perfusion study of primary hepatic tumors

Objective To compare and assess CT perfusion parameters and images between hepatocellular carcinoma (HCC) and hypervascular benign hepatic tumor (HBHT), and between liver neoplasm and tumor-free hepatic parenchyma by using multi-slice helical CT and liver perfusion software. Methods Hepatic perfusion scans were performed on 30 patients with HCCs, and 22 patients with HBHTs proven pathologically or clinically. Then the values of blood flow (BF), blood volume (BV), mean transit time (MTT), permeability surface (PS), hepatic arterial fraction (HAF) and time of arrival were calculated, and the perfusion maps for each were created. Results The BF, BV and HAF of HCC lesions were higher than those of the tumor-free hepatic parenchyma (P=0.000, 0.000 and 0.000). The BF and HAF of HBHT lesions were higher than those of the tumor-free hepatic parenchyma (P=0.004 and 0.000). The MTT of HCC lesions and HBHT lesions were shorter than each of the tumor-free hepatic parenchyma (P=0.015 and 0.027), and that of HCC lesions was also shorter than HBHT lesions (P=0.039). The HAF of HCC lesions and tumor-free hepatic parenchyma were higher than those of HBHT lesions and tumor-free hepatic parenchyma (P=0.036 and 0.044), respectively. Conclusion Hepatic perfusion parameters measured by using liver perfusion software cuoldan confirm significant difference not only between hepatic tumor lesions and tumor-free hepatic parenchyma, but also between malignant and benign hepatic tumors.