原发性肝癌肝脏灌注的多层螺旋CT对照研究

Control study of multislice CT perfusion in hepatocellular carcinoma

目的 探讨原发性肝癌MSCT肝血流灌注各参数的变化规律。方法 对 10例正常和 13例临床诊断为原发性肝癌患者 ,经右侧肘静脉以 6ml/s的速率注射对比剂 40ml,行肝血流灌注扫描。应用去卷积算法模式计算肝血流量(HBF)、血容量 (HBV )、平均通过时间 (MTT)、毛细血管表面通透性 (PS)和肝动脉灌注指数 (HAI)等。根据各参数图评价正常与原发性肝癌血流动力学状态。结果 全部受试者均按要求完成检查。 13例肝肿瘤患者HAI、BF明显高于正常组[HAI值 :0 .19± 0 .0 6vs 0 .5 8± 0 .2 0 ,P =0 .0 0 0 ;HBF值 :( 13 1.3 1± 3 8.2 5 )ml/( 10 0ml·min)vs ( 3 44.5 2± 95 .42 )ml/( 10 0ml·min) ,P =0 .0 0 2 ) ] ;MTT较正常组明显缩短 [( 12± 2 )svs ( 8± 4)s ,P =0 .0 2 8] ;HBV [( 2 7.49± 11.48)ml/10 0mlvs( 2 8.67± 16.81)ml/10 0ml ,P =0 .913 ]与PS[( 2 8.0 9± 15 .5 0 )ml/( 10 0ml·min)vs ( 3 1.3 6± 2 3 .98)ml/( 10 0ml·min) ,P =0 .678]两组间无明显统计学差异。结论 MSCT肝血流灌注参数HAI、HBF和MTT在正常和肝癌组织之间存在明显差异 。

Objective To study the parameters of multislice CT (MSCT) perfusion of hepatocellular carcinoma (HCC). Methods Dynamic CT with singe location sequences CT scan of the liver was obtained in 23 individuals, including 10 control subjects and 13 patients with HCC proven by clinic. Liver perfusion parameters such as total hepatic blood flow (HBF), hepatic blood volume (HBV), mean transit time (MTT), permeability of capillary vessel surface (PS) and hepatic arterial index (HAI) were calculated, and the change of the hemodynamic was estimated. Results Compared with the control group, HAI (0.19±0.06 versus 0.58±0.20, P =0.000) and HBF [(131.31±38.25) ml/(100 ml·min) versus (344.52± 95.42 ) ml/(100 ml·min), P =0.002] in HCC group increased significantly, and MTT [(12±2) s versus (8±4) s, P = 0.028 ] decreased significantly. HBV [(27.49±11.48) ml/100 ml versus (28.67±16.81) ml/100 ml, P =0.913] and PS [(28.09±15.50) ml/(100 ml·min) versus (31.36±23.98) ml/(100 ml·min), P =0.678] did not differ between the two groups. Conclusion Hepatic perfusion parameters measured with CT were significantly altered in HCC. Perfusion CT could be a new method to evaluate the blood supply of tumor.