【摘要】：目的評價320排螺旋CT灌注成像對小肝癌的血供及臨床診斷價值。方法收集2012-04-12-2014-04-12惠山區(qū)人民醫(yī)院住院治療并經(jīng)手術(shù)或活檢確診的20例小肝癌患者(小肝癌組)及20名正常志愿者(對照組)行320排容積CT全肝灌注成像,另設(shè)瘤外正常肝組織組(距癌組織≥2cm),采用最大斜率法計算小肝癌組、瘤外肝組織及對照組的肝動脈血流灌注量(hepatic arterial flow,HAF)、門靜脈血流灌注量(hepatic portal flow,HPF)和灌注指數(shù)(perfusion index,PI),比較各組間各灌注參數(shù)值的差異,評價小肝癌血流動力學(xué)改變;并通過色階賦值形成感興趣區(qū)(region of interest,ROI)灌注參數(shù)圖,通過與肝臟增強掃描比較,評價灌注掃描診斷小肝癌的價值。結(jié)果小肝癌組的HAF(mL·min-1·mL-1)值為(137.1±13.9),明顯高于瘤外正常肝組織組的(53.6±20.7),差異有統(tǒng)計學(xué)意義,t=1.794,P0.05;也明顯高于正常對照組的(55.8±16.1),差異有統(tǒng)計學(xué)意義,t=-0.089,P0.05。小肝癌組的HPF(mL·min-1·mL-1)值為(90.1±33.6),明顯低于瘤外正常肝組織組的(237.4±20.9)差異有統(tǒng)計學(xué)意義,t=-1.834,P0.05;也明顯低于正常對照組的(232.0±29.3),差異有統(tǒng)計學(xué)意義,t=0.514,P0.05。小肝癌組的PI率為(60.0±9.5)%,明顯高于瘤外正常肝組織組的(17.8±4.9)%,差異有統(tǒng)計學(xué)意義,t=2.132,P0.05;也明顯高于正常對照組的(19.1±4.3)%,差異有統(tǒng)計學(xué)意義,t=-0.157,P0.05。瘤外肝組織HAF和PI明顯高于正常對照組,HPF低于對照組,表現(xiàn)出與小肝癌相似的血供特點。320排CT全肝灌注掃描對小肝癌的確診率為80.0%(16/20),傳統(tǒng)三期增強掃描對小肝癌的確診率為30.0%(6/20),灌注掃描與三期增強掃描診斷小肝癌的準確率明顯高于傳統(tǒng)三期增強掃描,P0.05。結(jié)論 320排容積CT全肝灌注成像能有效地評價小肝癌血供情況,全肝灌注掃描較常規(guī)三期增強掃描對小肝癌的診斷準確率明顯提高,對小肝癌的早期診斷具有重要價值。
[Abstract]:Objective to evaluate the value of 320-slice spiral CT perfusion imaging in blood supply and clinical diagnosis of small hepatocellular carcinoma. Methods Twenty patients with small liver cancer (small liver cancer group) and 20 normal volunteers (control group) who were hospitalized in Huishan people's Hospital 2012-04-12-2014-04-12 and confirmed by operation or biopsy were studied. In addition, the normal liver tissue (鈮，

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