320排容积CT全肿瘤灌注测量与常规轴位最大层面测量对肝细胞癌诊断价值的对比分析
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摘要
目的比较全肿瘤灌注测量与轴位最大层面测量320排容积CT灌注成像诊断肝细胞癌的优缺点。方法56例肝细胞癌患者接受320排容积CT灌注成像检查,采用全肿瘤灌注和肿瘤轴位最大层面灌注测量肿瘤、瘤旁肝组织和正常肝组织的肝动脉灌注量(HAP)、门静脉灌注量(PVP)和肝动脉灌注指数(HAPI)。结果瘤体各灌注参数与瘤周肝组织或正常肝组织比,差异均有显著统计学意义(P<0.05);全肿瘤灌注测量值与轴位最大层面测量法得到的各参数均无统计学差异(P>0.05);两名医生应用两种方法测量获得的三种组织测量值无显著性统计学差异(P>0.05)。结论使用320排容积CT灌注成像检查肝细胞癌瘤体,应用轴位最大层面法测量可以获得同样的测量值,但减轻了工作量。
Objective To compare the diagnosis of total tumor perfusion and maximum diameter measurement in assessing CT scan imaging in patients with hepatocellular carcinoma(HCC). Methods Fifty-six patients with hepatocellular carcinoma between January 2013 and January 2016 were recruited in this study. The320 row volume CT perfusion imaging was performed. The parameters of hepatic perfusion were calculated,including hepatic artery perfusion(HAP),portal vein perfusion(PVP) and hepatic perfusion index(HAPI). The total tumor perfusion and the maximum diameter of tumors were applied to record the parameters of tumoral,peritumoral and normal liver tissues. R esults The HAP and HAPI of tumors were much higher,while the PVP of tumors were much lower than those in peritumoral or normal liver tissue by both measurements(P<0.05);there was no significant difference between parameters of tumors by both measurements(P >0.05),and there was also no significant difference between parameters by two doctors who measure the parameters(P>0.05). Conclusion The total tumor perfusion or maximum diameter measurement in assessing CT scan imaging in patients with hepatocellular carcinoma is good,but the latter might be convenient and simple.
Objective To compare the diagnosis of total tumor perfusion and maximum diameter measurement in assessing CT scan imaging in patients with hepatocellular carcinoma(HCC). Methods Fifty-six patients with hepatocellular carcinoma between January 2013 and January 2016 were recruited in this study. The320 row volume CT perfusion imaging was performed. The parameters of hepatic perfusion were calculated,including hepatic artery perfusion(HAP),portal vein perfusion(PVP) and hepatic perfusion index(HAPI). The total tumor perfusion and the maximum diameter of tumors were applied to record the parameters of tumoral,peritumoral and normal liver tissues. R esults The HAP and HAPI of tumors were much higher,while the PVP of tumors were much lower than those in peritumoral or normal liver tissue by both measurements(P<0.05);there was no significant difference between parameters of tumors by both measurements(P >0.05),and there was also no significant difference between parameters by two doctors who measure the parameters(P>0.05). Conclusion The total tumor perfusion or maximum diameter measurement in assessing CT scan imaging in patients with hepatocellular carcinoma is good,but the latter might be convenient and simple.
引文
[1]马国林,姜慧杰,陈敏,等.肝癌结节血液动力学变化多层螺旋CT灌注成像观察.中华医学杂志,2013,93(15):1146-1149.
[2]马恩森,任安,王武,等.高速CT灌注成像感兴趣区的选择对肺癌灌注参数的影响.中华放射学杂志,2012,46(9):779-783.
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[9]颜荣华,谢斯栋,王劲,等.320排CT Surt-start成像与动态容积扫描对肝移植术后肝动脉并发症的评价.中华医学杂志,2014,94(43):3374-3377.
[10]马淑华,金鑫,黎叶芳,等.多层螺旋CT灌注成像诊断肝硬化分级的临床价值分析.医学影像学杂志,2014,23(12):2129-2131,2138.
[11]肖国明.CT灌注成像在诊断肝纤维化、肝硬化中的应用.中国医药科学,2015,12(13):169-171,175.
[12]曲阳春,刘桂锋,刘云霞,等.320排CT灌注成像在肝脏肿瘤诊断中的应用价值.中国老年学杂志,2013,33(2):425-426.
[13]李保全,赵宏伟,白雪峰.肝硬化合并小肝癌与肝硬化再生结节多层螺旋CT灌注成像分析.实用医药杂志,2014,31(11):1000-1001.
[14]Peynircioglu B,Hizal M,Cil B,et al.Quantitative liver tumor blood volume measurements by a C-arm CT post-processing software before and after hepatic arterial embolization therapy:comparison with MDCT perfusion.Diagn Interv Radiol,2015,21(1):71-77.
[15]Bevilacqua A,Barone D,Malavasi S,et al.Quantitative assessment of effects of motion compensation for liver and lung tumors in CT perfusion.Acad Radiol,2014,21(11):1416-1426.
[16]Hansen ML,Norling R,Lauridsen C,et al.Computed tomography(ct)perfusion in abdominal cancer:technical aspects.Diagnostics(Basel),2013,3:261-270.
[2]马恩森,任安,王武,等.高速CT灌注成像感兴趣区的选择对肺癌灌注参数的影响.中华放射学杂志,2012,46(9):779-783.
[3]Goh V,Halligan S,Gharpuray A,et al.Quantitative assessment of colorectal cancer tumor vascular parameters by using perfusion CT:influence of tumor region of interest.Radiology,2008,247(3):726-732.
[4]Motosugi U,Ichikawa T,Sou H,et al.Multi-organ perfusion CT in the abdomen using a 320-detector row CT scanner:preliminary results of perfusion changes in the liver,spleen,and pancreas of cirrhotic patients.Eur J Radiol,2012,81(10):2533-2537.
[5]Ma GL,Bai RJ,Jiang HJ,et al.Early changes of hepatic hemodynamics measured by functional CT perfusion in a rabbit model of liver tumor.Hepatobiliary Pancreat Dis Int,2012,11(4):407-411.
[6]Frampas E,Lassau N,Zappa M,et al.Advanced hepatocellular carcinoma:Early evaluation of response to targeted therapy and prognostic value of perfusion CT and dynamic contrast enhanced-ultrasound.Preliminary results.Eur J Radiol,2013,82(5):e205-e211.
[7]Sanelli PC,Nicola G,Johnson R,et al.Effect of training and experience on qualitative and quantitative CT perfusion data.AJNR,2007,28(3):428-432.
[8]Kanda T,Yoshikawa T,Ohno Y,et al.Perfusion measurement of the whole upper abdomen of patients with and without liver diseases:initial experience with 320-detector row CT.Eur J Radiol,2012,81(10):2470-2475.
[9]颜荣华,谢斯栋,王劲,等.320排CT Surt-start成像与动态容积扫描对肝移植术后肝动脉并发症的评价.中华医学杂志,2014,94(43):3374-3377.
[10]马淑华,金鑫,黎叶芳,等.多层螺旋CT灌注成像诊断肝硬化分级的临床价值分析.医学影像学杂志,2014,23(12):2129-2131,2138.
[11]肖国明.CT灌注成像在诊断肝纤维化、肝硬化中的应用.中国医药科学,2015,12(13):169-171,175.
[12]曲阳春,刘桂锋,刘云霞,等.320排CT灌注成像在肝脏肿瘤诊断中的应用价值.中国老年学杂志,2013,33(2):425-426.
[13]李保全,赵宏伟,白雪峰.肝硬化合并小肝癌与肝硬化再生结节多层螺旋CT灌注成像分析.实用医药杂志,2014,31(11):1000-1001.
[14]Peynircioglu B,Hizal M,Cil B,et al.Quantitative liver tumor blood volume measurements by a C-arm CT post-processing software before and after hepatic arterial embolization therapy:comparison with MDCT perfusion.Diagn Interv Radiol,2015,21(1):71-77.
[15]Bevilacqua A,Barone D,Malavasi S,et al.Quantitative assessment of effects of motion compensation for liver and lung tumors in CT perfusion.Acad Radiol,2014,21(11):1416-1426.
[16]Hansen ML,Norling R,Lauridsen C,et al.Computed tomography(ct)perfusion in abdominal cancer:technical aspects.Diagnostics(Basel),2013,3:261-270.