肝炎后肝硬化继发肝癌患者小肝癌病灶320排CT灌注成像HAP、HPI、HPP变化及其临床意义

摘要

目的 观察肝炎后肝硬化继发原发性肝癌患者小肝癌病灶320排CT灌注成像肝动脉灌注量(HAP)、门静脉灌注量(HPP)、肝动脉灌注指数(HPI)变化,并探讨其临床意义.方法 对20例肝炎后肝硬化继发原发性肝癌患者行320排CT肝脏动态容积灌注扫描,获得肿瘤组织及肝硬化组织的CT灌注值HAP、HPP、HPI.结果 小肝癌病灶的HAP为(85.42±23.29)mL/(min·100 mL),HPP为(83.71±28.28)mL/(min·100 mL),HPI为(54.99±13.15)%;肝硬化组织的HAP为(26.88±10.02)mL/(min·100 mL),HPP为(158.99±23.80)mL/(min·100 mL),HPI为(15.57±5.95)%.小肝癌病灶和肝硬化组织HAP、HPI、HPP相比P均<0.05.结论 与肝硬化组织比较,小肝癌病灶320排CT灌注成像HAP、HPI升高,HPP降低.320排CT灌注成像HAP、HPI、HPP有助于辅助诊断小肝癌.%Objective To observe the changes of hepatic arterial perfusion (HAP), portal vein perfusion (HPP), and hepatic arterial perfusion index ( HPI) in 320-slice CT perfusion imaging of small hepatocellular carcinoma ( HCC) secondary to liver cirrhosis induced by hepatitis and to investigate its clinical significance .Methods Perfusion scans were performed with 320-slice CT in 20 patients with primary HCC secondary to liver cirrhosis induced by hepatitis .The CT per-fusion values of tumor tissues and liver cirrhosis tissues were obtained , including HAP, HPP, and HPI.Results In the HCC tissues, HAP was (85.42 ±23.29) mL/(min· 100 mL), HPP was (83.71 ±28.28 ) mL/(min· 100 mL), and HPI was 54.99%±13.15%;in the liver cirrhosis tissues, HAP was (26.88 ±10.02) mL/(min· 100 mL), HPP was (158.99 ±23.80) mL/(min· 100 mL), and HPI was 15.57%±5.95%.Significant differences were found in all the perfusion parameters between the HCC tissues and liver cirrhosis tissues (all P<0.05).Conclusions Compared with the liver cirrhosis tissues, small HCC tissues have significantly higher HAP and HPI , and lower HPP in 320-slice CT perfusion imaging.The liver 320-slice CT perfusion imaging of HAP , HPP, and HPI is useful for monitoring the canceration of cir-rhosis nodules and providing supplementary information for the diagnosis of early HCC .