CT对于肝脏良性占位性病变及肝癌的鉴别诊断价值分析

目的:探讨CT对于肝脏良性占位性病变及肝癌的鉴别诊断价值。方法:收取2013年3月至2016年3月我院收治的肝脏良性占位性病变及肝癌患者101例作为研究对象,按照病变类型将其分为A、B、C三组。其中A组包含原发性肝癌患者32例,B组包含肝转移癌患者28例,C组包含肝血管瘤患者41例。采用CT全肝灌注扫描模式对三组患者占位病灶组织、病灶周围组织及正常肝脏组织灌注参数进行比较。结果:三组占位病灶组织,B组患者肝动脉灌注量(HAP)最低,C组患者HAP最高;A组患者门静脉灌注量(PVP)最低,C组患者PVP最高,三组两两比较均有显著差异(P0.05)。C组总肝灌注量(TLP)明显高于A组和B组(P0.05),A、B组间无统计学差异(P0.05)。三组肝动脉灌注指数(HPI)无明显差异(P0.05);B组病灶周围组织HAP及HPI明显高于A、C组(P0.05),A、C组间无统计学差异(P0.05);三组PVP及TLP差异不显著(P0.05);三组正常肝脏组织CT灌注参数均无显著差异(P0.05)。结论:CT灌注成像对于原发性肝癌、肝转移癌及肝血管瘤具有一定的鉴别诊断价值,但明确诊断仍需结合其他检测方法进行。

Clinical Value of CT in Differential Diagnosis of Liver Benign Lesion and Liver Cancer

ABSTRACT Objective: To explore the clinical value of CT in differential diagnosis of liver benign lesion and liver cancer. Methods: 101 cases of liver benign lesion or liver cancer accepted in our hospital from March 2013 to March 2016 were selected and divided into group A, B and C according to different diseases. There were 32 patients of primary liver cancer in group A, 28 cases of liver metastasis cancer in group B and 41 cases of hepatic hemangioma in group C. The parameters of perfusion CT of local focus tissues, surrounding tissues and normal tissues of 3 groups were observed and compared. Results: In the comparison of local focus tissues, group B had the lowest and group C had the highest hepatic arterial perfusion (HAP), group A had the lowest and group C had the highest portal venous perfusion (PVP). The differences of 3 groups had statistically significance (P<0.05). The total liver perfusion (TLP) of group C was obviously higher than that of group A and B (P<0.05), and there were no difference between them (P>0.05). HPI of 3 groups had no difference (P>0.05). The HAP of focus surrounding tissues of group B was obviously higher than group A and C (P<0.05), and there were no difference between them (P>0.05). PVP and TLP of 3 groups had no difference (P>0.05). The parameters of normal liver tissues of 3 groups had no difference (P>0.05). Conclusion: The perfusion CT has a certain value in differential diagnosis of liver benign lesion and liver cancer, but we should clarify diagnosis with some other detection.