肝细胞癌、肝血管瘤及FNH的双源CT灌注成像对比研究

Comparative Study of Dual Source CT Perfusion Imaging in Hepatocellular Carcinoma,Hepatic Hemangioma and Focal Nodular Hyperplasia

目的探讨DSCT灌注(DSCTP)对肝细胞癌、肝血管瘤及FNH的诊断意义。方法通过对10例原发性肝细胞癌、8例肝血管瘤及8例FNH的病灶实性部分、边缘部分以及正常肝实质的CT灌注参数分析,研究各组病灶实质部分的参数。结果BF、BV、HAP值在肝细胞癌、血管瘤及FNH三组中均较正常肝实质增高:其中BF、BV由高至低依次为FNH、肝细胞癌、血管瘤(P<0.05),HAP在肝细胞癌、血管瘤间无显著差异(P>0.05),但明显低于FNH(P<0.01);TTS及TTP在肝细胞癌组及FNH组低于正常肝实质,在血管瘤组则高于正常肝实质,由高至低依次为血管瘤、肝细胞癌、FNH(P<0.05);PS值在肝细胞组及FNH组中高于正常肝实质(P<0.05),血管瘤组则与正常肝实质无明显差异(P>0.05),由高至低依次为FNH、肝细胞癌、血管瘤(P<0.05)。结论 DSCT灌注参数反映出肝细胞癌、血管瘤及FNH肿瘤结节的血供类型与分布特点,具有鉴别诊断的临床价值。

Objective To investigate the dual-source CT perfusion imaging（CTPI） features of hepatocellular carcinoma（HCC）, hepatic laemangioma and Focal nodular hyperplasia（FNH） and its diagnose value. Methods CT perfusion scans were performed with dual-source CT in 10 HCC patients, 8 hepatic hemangioma patients and 8 FNH patients, perfusion parameter of center and edge of lesions, normal liver tissue were collected and analyzed. Results The values of blood flow（BF）, blood volume （BV）, Hepatic arterial perfusion（HAP）were higher than normal liver tissue in HCC group, hepatic hemangioma group and FNH group（P〈0.05）, The values of BF, BV was the highest for FNH group, followed by HCC group, hepatic hemangioma group（P〈0.05）, There were no statistical differences between the values of BF, BV in HCC group and hepatic hemangioma group（P〉0.05）, but both significantly lower than FNH group（P 〈0.01）. The values of time to start（TTS）, time to peak（TTP） were significantly lower than normal liver tissue in HCC group and FNH group（P〈0.05）, but significantly higher than normal liver tissue in hepatic hemangioma group, the values of TTS, TTP was the highest for hepatic hemangioma group, followed by HCC group, FNH group（P〈0.05）. The values of permeability of surf：ace area product（PS） were higher than normal liver tissue in HCC group and FNH group, but were no statistical differences in hepatic hemangioma group（P〉0.05）, the values of PS was the highest for FNH group, followed by HCC group, hepatic hemangioma group（P〈0.05）. Conclusion Dual-source CTPI can provide much more information about the hemodynantics, blood supply and distribution features of HCC, hepatic hemangioma and FNH, which is helpful in differential diagnosing and clinical value.