[多层螺旋CT全肝灌注成像对肝脏常见肿瘤血流情况的评估]

[Evaluation of the blood flow in common hepatic tumors by multi-slice spiral CT whole-liver perfusion imaging].

作者信息

Li Mengdi, Chen Yong, Gao Zhiling, Zhu Kai, Yin Xin

机构信息

Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210000, China.

Email:

出版信息

Zhonghua Zhong Liu Za Zhi. 2015 Dec;37(12):904-8.

PMID:26887618

Abstract

OBJECTIVE

To study the characteristics of blood flow in common hepatic tumors by 256-slice spiral CT whole-liver perfusion imaging.

METHODS

Seventy-one patients with hepatic tumors were examined retrospectively by 256-slice spiral CT whole-liver perfusion. Among them, twenty-seven cases were of primary hepatic cancer, twenty-four cases of hepatic hemangioma, and twenty cases of hepatic metastases.Regions of interest (ROIs) were placed in the tumor parenchyma (Area A), peritumoral hepatic parenchyma (Area B), and normal hepatic parenchyma (Area C), respectively. The time density curves (TDC) were drawn, and perfusion parameters including hepatic arterial perfusion(HAP), portal venous perfusion(PVP), total liver perfusion(TLP) and hepatic erfusion index(HPI) were obtained. The values of ROIs were measured, and the perfusion parameters in the areas A, B, C of different hepatic tumors were statistically analyzed.

RESULTS

The values of HAP, PVP, HPI in the tumor parenchyma of primary hepatic carcinoma were (20.00 ± 11.41)ml · min(-1) · 100 ml(-1,) (32.31 ± 21.06)ml · min(-1) · 100 ml(-1,) (52.31 ± 30.55)ml · min(-1) · 100 ml(-1,) and (39.67 ± 11.19)%, showing significant difference as compared with those in peritumoral hepatic parenchyma and in normal hepatic parenchyma(P<0.05). The values of HAP, TLP, and HPI in the tumor parenchyma of hepatic hemangioma were (40.39 ± 29.23)ml · min(-1) · 100 ml(-1,) (132.72 ± 132.65) ml · min(-1) · 100 ml(-1,) and (35.51 ± 15.12)%, were significantly different as compared with those in the peritumoral hepatic parenchyma and in normal hepatic parenchyma(P<0.05). The values of HAP, PVP, HPI in the tumor parenchyma of hepatic metastases were (17.43 ± 12.27)ml · min(-1) · 100 ml(-1,) (36.19 ± 34.99) ml · min(-1) · 100 ml(-1,) and (37.86 ± 14.49)%, significantly different as compared normal hepatic parenchyma (P<0.05). The HAP, PVP, and TLP of tumor tissue and the PVP and HPI of peritumoral tissue in different hepatic tumors were statistically significantly different (P<0.05).

CONCLUSIONS

The multi-slice spiral CT whole-liver perfusion has certain value in the diagnosis of common hepatic tumors. Perfusion parameters in different areas of common hepatic tumors have their own hemodynamic characteristics.

摘要

目的

通过256层螺旋CT全肝灌注成像研究常见肝脏肿瘤的血流特点。

方法

回顾性分析71例肝脏肿瘤患者的256层螺旋CT全肝灌注检查资料。其中原发性肝癌27例，肝血管瘤24例，肝转移瘤20例。分别在肿瘤实质（A区）、瘤周肝实质（B区）及正常肝实质（C区）设置感兴趣区（ROI），绘制时间-密度曲线（TDC），获得肝动脉灌注（HAP）、门静脉灌注（PVP）、全肝灌注（TLP）及肝灌注指数（HPI）等灌注参数。测量各ROI数值，对不同肝脏肿瘤A、B、C区的灌注参数进行统计学分析。

结果

原发性肝癌肿瘤实质区的HAP、PVP、HPI值分别为（20.00±11.41）ml·min⁻¹·100 ml⁻¹、（32.31±21.06）ml·min⁻¹·100 ml⁻¹、（52.31±30.55）ml·min⁻¹·100 ml⁻¹及（39.67±11.19）%，与瘤周肝实质及正常肝实质比较差异有统计学意义（P<0.05）。肝血管瘤肿瘤实质区的HAP、TLP、HPI值分别为（40.39±29.23）ml·min⁻¹·100 ml⁻¹、（132.72±132.65）ml·min⁻¹·100 ml⁻¹及（35.51±15.12）%，与瘤周肝实质及正常肝实质比较差异有统计学意义（P<0.05）。肝转移瘤肿瘤实质区的HAP、PVP、HPI值分别为（17.43±12.27）ml·min⁻¹·100 ml⁻¹、（36.19±34.99）ml·min⁻¹·100 ml⁻¹及（37.86±14.49）%，与正常肝实质比较差异有统计学意义（P<0.05）。不同肝脏肿瘤的肿瘤组织HAP、PVP、TLP及瘤周组织PVP、HPI差异有统计学意义（P<0.05）。