【摘要】：目的:探討雙源CT灌注成像在肝轉(zhuǎn)移瘤診斷及治療中的臨床應(yīng)用價值。方法:應(yīng)用雙源CT行全肝CT灌注檢查,獲得血流量(BF)、血容量(BV)、達峰時間(TTP)、肝動脈灌注量(ALP)、門靜脈灌注量(PVP)、肝動脈灌注指數(shù)(HPI)等灌注參數(shù)及灌注偽彩圖像,并進行相應(yīng)統(tǒng)計學(xué)分析。結(jié)果:(1)肝轉(zhuǎn)移瘤肝動脈灌注量及動脈灌注指數(shù)較周圍肝實質(zhì)均升高,而門靜脈灌注量則降低,達峰時間明顯縮短。(2)肝轉(zhuǎn)移瘤TDC(時間密度曲線)變化較大,但均表現(xiàn)出比較明顯上升坡度,峰值出現(xiàn)時間較早。(3)富血供與乏血供轉(zhuǎn)移瘤灌注圖有一定差異,在ALP及HPI偽彩圖上,病灶外周皆呈高灌注表現(xiàn),乏血供轉(zhuǎn)移瘤中心多呈低灌注,富血供轉(zhuǎn)移瘤中心不均勻高灌注,周圍肝實質(zhì)呈略低灌注;在PVP圖像上,癌灶呈低灌注,周圍肝實質(zhì)呈高灌注。(4)HPI和ALP灌注偽彩圖像中顯示的病灶面積較CT增強圖像面積更大。結(jié)論:雙源CT灌注可反映肝轉(zhuǎn)移瘤血供情況,對腫瘤真實大小的評估、轉(zhuǎn)移瘤術(shù)前指導(dǎo)及術(shù)后效果評價具有重要意義。
[Abstract]:Objective: to evaluate the clinical value of dual-source CT perfusion imaging in the diagnosis and treatment of hepatic metastasis. Methods: the whole liver CT perfusion was performed with dual-source CT. The blood flow (BF), blood volume, (BV), peak time, (TTP), hepatic artery perfusion volume, (ALP), portal vein perfusion volume (PVP), were obtained. The perfusion parameters such as hepatic artery perfusion index (HPI) and perfusions were analyzed statistically. Results: (1) the arterial perfusion volume and arterial perfusion index of hepatic metastases were higher than those of the surrounding liver parenchyma, while the portal vein perfusion decreased and the peak time was shortened. (2) the TDC (time density curve) of hepatic metastatic tumors was significantly changed, while the hepatic arterial perfusion volume and arterial perfusion index were higher than those of the surrounding liver parenchyma. (3) the perfusion images of metastatic tumors were different between the rich blood supply and the lack of blood supply. On the ALP and HPI pseudo-color images, the periphery of the lesion showed high perfusion, and the peak value appeared earlier. (3) there was a certain difference in the perfusion pattern between the rich blood supply and the lack of blood supply in the peripheral part of the lesion. There were low perfusion in the center of the metastatic tumor with low blood supply, uneven and high perfusion in the center of the metastatic tumor with rich blood supply, and slightly lower perfusion in the surrounding liver parenchyma. On the PVP images, the tumor focus showed low perfusion and the surrounding liver parenchyma showed high perfusion. (4) the lesion area in HPI and ALP perfusions was larger than that in CT enhanced images. Conclusion: dual-source CT perfusion can reflect the blood supply of hepatic metastatic tumor, and it is of great significance to evaluate the true size of the tumor, preoperative guidance and postoperative evaluation of the metastatic tumor.
【作者單位】： 濱州醫(yī)學(xué)院附屬醫(yī)院;
【分類號】：R735.7

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