320排容积CT灌注成像在36例小肝癌血流灌注特点及病理分化程度评估中的临床价值

Clinical value of 320-detector row volume CT perfusion imaging in the assessment of blood flow perfusion characteristics and degree of pathological differentiation of 36 patients with small hepatocellular carcinoma

[目的]探讨320排容积CT灌注成像(CTP)在小肝癌(SHCC)血流灌注特点及病理分化程度评估中的应用价值.[方法]选择经病理检查证实为SHCC的36例,均给行CTP,测量肿瘤区域、瘤周组织及远端肝组织的肝动脉血流灌注量(HAF)、门静脉血流灌注量(HPF)及肝动脉灌注指数(HPI),定量分析SHCC的血流灌注特点及病理分型程度与灌注参数间的关系.[结果] SHCC肿瘤区域HAF,HPI均明显高于瘤周组织和远端肝组织(P<0.05);瘤周组织与远端肝组织HAF,HPI间差异均无统计学意义(P>0.05);肿瘤区域HAF,HPI与肿瘤病理分化程度呈负相关.[结论] 320排容积CTP可定量反映早期SHCC的血流灌注特点,可有效评估SHCC的病理分化程度.

OBJECTIVE To explore the application value of 320-detector row volume CT perfusion imaging(CTP) in the assessment of blood flow perfusion characteristics and degree of pathological differentiation of 36 patients with small hepatocellular carcinoma(SHCC). METHODS 36 patients with SHCC confirmed by pathological examination were selected. CTP was performed on all cases. Hepatic arterial flow(HAF), hepatic portal flow(HPF), and hepatic arterial perfusion index(HPI) in the tumor area, peritumoral tissue and distal normal tissue were measured respectively. The relationship between blood perfusion features and the pathological classification degree of SHCC and perfusion parameters was quantitatively analyzed. RESULTS The HAF and HPI of SHCC tumor area were significantly higher than those of the peritumoral tissues and the distal liver tissues(P<0.05). There was no significant difference in HAF and HPI between the peritumoral tissues and the distal liver tissues(P>0.05). The HAF and HPI of tumor area were negatively correlated with the degree of tumor differentiation. CONCLUSION 320-detector row CT perfusion imaging could quantitatively reflect the blood perfusion characteristics of early SHCC, and effectively evaluate the degree of pathological differentiation of SHCC.