能谱CT估算原发性肝癌其血供比例的初步研究

Energy Spectral CT Scans for Estimation of Hepatic Artery Index of Liver Cancer: A Preliminary Study

目的利用能谱CT(碘基图)对肝癌患者及正常人群进行测量,估算不同病变其血供比例,并对其进行分析。方法对22例原发性肝癌进行分析,20名正常人群作为对照组,测得病变动脉期及静脉期碘含量数值,并得出肝动脉期与静脉期百分比进行统计学分析,同时对肝癌患者依据Child-Pugh分级进行分组,并与正常人群进行方差分析。结果利用正常肝脏及肝癌血供比例进行比较,得出两组数据之间差异具有统计学意义(t值=25.34,P<0.05),正常人群及Child-Pugh分级对多组均数进行方差分析(F值=15.58),Child-Pugh组别较正常人群差异具有统计学意义(P值分别为0.007、0.000、0.000),Child-Pugh A组较Child-Pugh B组及C组差异亦具有统计学意义(P值分别为0.008、0.009),但Child-Pugh B组与Child-Pugh C组之间差异无统计学意义(P=0.316)。结论利用能谱CT测量其动脉期及静脉期碘含量之比,可以估算出肝癌其血供比例较正常肝组织血供比例发生改变,从而更简便地发现肝癌其血供比例的改变。

Objective To estimate the proportion of hepatic blood supply in normal subjects and in patients with liver cancer by using energy spectral CT （ iodine figure）. Methods A total of 22 patients with primary liver cancer （ study group） and 20 healthy subjects （control group） were enrolled in this study. The iodine values within the lesions in arterial and venous phase were determined, and the percentage of blood flow in hepatic arterial phase and venous phase were thus obtained. The results were statistically analyzed. According to Child-Pugh criterion, the patients were divided into different groups. The results were compared with normal population by using variance analysis. Results Statistically significant differences in the blood supply existed between normal liver tissue and liver cancer （ t = 25.34, P 〈 0.05 ）. Variance anal- ysis showed that the blood supply in normal population was significantly different with Child-Pugh group （P = 0. 007 ,P = 0. 007 and P = 0. 000 respectively）. Significant differences in the blood supply existed between Child-Pugh A and Child-Pugh B as well as between Child-Pugh A and Child-Pugh C （P = 0. 008 ,P = 0. 009 respectively）, while the difference between Child-Pugh B and Child-Pugh C was not significant （P = 0.316）. Conclusion Iodine content in the tissue which is measured by energy spectral CT can estimate the blood supply in the tissue. This technique can estimate the blood supply in the liver cancer and normal liver tissue, thus the change of blood supply proportion in liver cancer can be easily detected.