肝细胞癌多层螺旋CT灌注成像特征与病理学特征的相关性分析

目的探讨运用多层螺旋cT对肝细胞癌（HCC）进行血流灌注成像检查时的参数变化特征，并分析其与病理学特征的相关性。方法选取43例HCC患者作为观察对象，于手术前均接受多层螺旋CT灌注成像检查，分别测量并记录癌组织以及正常肝组织的灌注成像参数：门静脉灌注量（HPP）、肝动脉灌注量（HAP）、肝动脉灌注指数（HAI），并与术后相应组织标本的病理学检查结果[微血管密度（MVD）和病理分级]进行比较分析。结果与正常肝组织比较，癌组织的HAP、HAI以及MVD均明显增高，而癌组织的HPP明显下降，差异均有统计学意义（P〈0．05）；癌组织的HAP、HAI分别与MVD呈正相关；高分化癌HAP、HAI〈中分化癌HAP、HAI小于低分化癌的HAP、HAI，差异具有统计学意义（P均〈0．05）；高分化癌HPP〉中分化癌HPP〉低分化癌HPP，差异具有统计学意义（P均〈0．05）。结论多层螺旋CT灌注成像检查能定量分析HCC的血流灌注成像参数特征，为临床对HCC的正确诊断、病理分级、治疗决策以及预后评估提供参考依据。

Objective To study the characteristics of multilayer spiral computed tomography （ MSCT ） perfusion imaging in hepatoceUular carcinoma （ HCC ） , and its correlation with pathology. Methods 43 patients who underwent tumor resection surgery in our hospital were selected as the research objects during 2014-09 to 2016-02.All patients were examined by MSCT perfusion imaging before surgery. The perfusion imaging parameters of carcinoma tissues and normal liver tissue were measured and recorded： hepatic portal perfusinn （ HPP ） , hepatic artery perfusion （ HAP ） , hepatic arterial perfusion index （ HA1 ） and compared with the pathologic results of postoperative tissue samples： microvessel density （ MVD ） and pathological classification. Results Compared with normal liver tissue, HAP, HAl and MVD of cancer tissue were significantly increased, and HPP was significantly reduced, difference had significant statistical significance （P〈0.05） ; HAP, HAI of cancers were positively correlated with MVD; HAP, HAI in high differentiation〈 HAP, HAI in middle differentiation〈 HAP, HAI in low differentiation, difference had significant statistical significance （ P〈0.05 ） ;HPP in high differentiation 〉HPP in middle differentiation 〉HPP in low differentiation, difference had significant statistical significance （P〈0.05） . Conclusion MSCT perfusion imaging can quantitative analysis of the characteristics of perfusion imaging parameters in HCC and provide references for clinical diagnosis, pathological classification, treatment and prognostic evaluation.