七期增强CT扫描评估肝癌血流灌注特性的可行性研究

The feasibility study of 7-phase contrast enhanced CT scanning in evaluating perfusion characteristics of hepatic carcinoma

目的通过对比肝癌患者七期增强CT与常规CT灌注成像所得到的灌注伪彩图、灌注参数及辐射剂量,探讨七期增强CT评估肝癌血流灌注特性的可行性。方法对30例肝癌患者行25期CT灌注扫描,将得到的图像导入后处理工作站,获得各灌注参数的伪彩图并测量肿瘤区、肿瘤活性区及相对正常肝实质区的灌注参数,包括肝动脉灌注量(hepatic arterial perfusion,HAP)、门静脉灌注量(portal vein perfusion,PVP)、肝动脉灌注指数(hepatic perfusion index,HPI),同时记录扫描辐射剂量;选取25期CT灌注图像中的7期导入CT Kinetics后处理软件,得到相应的灌注伪彩图及肿瘤区、肿瘤活性区、相对正常肝实质区的灌注参数,并计算辐射剂量。比较七期增强CT扫描与常规CT灌注成像灌注伪彩图质量评分的差异,探究七期增强CT扫描及常规CT灌注成像中肿瘤区、肿瘤活性区及相对正常肝实质区各灌注参数的相关性,并比较七期增强CT扫描与常规CT灌注成像辐射剂量的差异。结果1)七期增强CT与常规CT灌注各灌注参数伪彩图所得质量评分差异无统计学意义(P>0.05);2)七期增强CT与常规CT灌注在肿瘤区及肿瘤活性区的HAP、PVP、HPI相关性较好;相对正常肝实质区的HAP、PVP、HPI有一定的相关性;3)七期增强CT扫描的辐射剂量明显低于常规CT灌注扫描,差异有统计学意义(P<0.05)。结论七期增强CT扫描可以模拟常规25期CT灌注评价肿瘤的血流灌注特征,同时显著降低辐射剂量。

Objective By comparing the perfusion pseudo-color map,perfusion parameters and radiation dose obtained by seven-phase enhanced CT with conventional CT perfusion imaging,the feasibility of 7-phase enhanced CT in evaluating perfusion characteristics of hepatic carcinoma was explored.Methods Thirty patients with hepatic carcinoma underwent conventional 25-phase CT perfusion scans,and the obtained image data were imported into the post-processing workstation to obtain pseudo-color maps of the following perfusion parameters:hepatic arterial perfusion(HAP),portal vein perfusion(PVP)and hepatic perfusion index(HPI),then the perfusion parameters of tumor area,tumor active area and relative normal liver parenchyma were measured and the radiation dose was recorded.Seven phases selected from conventional 25-phase CT perfusion were imported into CT Kinetics post-processing software,the perfusion pseudo-color map and perfusion parameters of tumor area,tumor active area as well as relative normal liver parenchyma were obtained,the radiation dose was calculated.The difference of the quality scores of perfusion pseudo-color maps and radiation dose were compared between 7-phase contrast enhanced CT scan and the conventional CT perfusion,the consistency of the perfusion parameters in the tumor area,tumor active area and relative normal liver parenchyma in the 7-phase enhanced CT scan and conventional CT perfusion imaging was explored.Results 1)There was no significant difference in the quality scores of the pseudo-color maps between 7-phase contrast enhanced CT and conventional CT perfusion(P>0.05);2)The HAP,PVP,HPI in the tumor area and the tumor active area of the 7-phase contrast enhanced CT had a good correlation with that of the conventional CT perfusion,The HAP,PVP,HPI in the relative normal liver parenchyma of the 7-phase contrast enhanced CT have a certain correlation with the conventional CT perfusion;3)The radiation dose of the 7-phase enhanced CT scan was significantly lower than that of the conventional CT perfusion,and the difference was statistically significant(P<0.05).Conclusion 7-phase enhanced CT scan can simulate the conventional 25-phase CT perfusion to evaluate the perfusion characteristics of hepatic carcinoma,while significantly reducing the radiation dose.