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目的探讨运用平板探测器CT灌注成像(FD-CTP)在肝细胞癌(HCC)中评估血容量(BV)的可行性,并与传统CT灌注成像(CTP)进行比较。方法选择20例HCC患者,其中男性13例,女性7例;年龄36~82岁,中位年龄58岁。先后进行传统CTP检查和FD-CTP检查,首先运用CTP测量肿瘤和肝实质区BV值(CTP-BV),再运用FD-CTP测量相对应区的BV值(FD-BV),根据下列等式提取CTP-BV中的动脉灌注产生部分(CTP-BVarterial):CTP-BVarterial=CTP-BV×HPI(HPI为肝动脉灌注指数)。另外假设:肝肿瘤的CTP-BVarterial/肝实质的CTP-BVarterial=CTP-BVarterial相对值,肝肿瘤的FD-BV/肝实质的FD-BV=FD-BV相对值。分析两种检查BV值的关系。结果 CTP-BVarterial和FD-BV绝对值之间有良好的相关性(HCC:r=0.903;肝实质:r=0.920;P<0.001)。Bland-Altman检验显示,CTP-BVarterial和FD-BV相对值的平均差值为-0.15±0.24。结论 HCC或肝实质的FD-BV和CTP-BVarterial值均具有良好的可比性,肝脏FD-CTP检查在临床上具有可行性。
Objective To investigate the feasibility of assessing blood volume (BV) in hepatocellular carcinoma (HCC) by using flat detector CT perfusion imaging (FD-CTP) and compare with traditional CT perfusion imaging (CTP). Methods Twenty patients with HCC were selected, including 13 males and 7 females, aged 36-82 years, with a median age of 58 years. The traditional CTP examination and FD-CTP examination were carried out successively. The CTP-BV value of tumor and liver parenchyma was measured firstly by CTP, and the BV value (FD-BV) of corresponding area was measured by FD-CTP. CTP-BVarterial was extracted from CTP-BV: CTP-BVarterial = CTP-BV × HPI (HPI was hepatic arterial perfusion index). It is also hypothesized that the CTP-BVarterial / CTP-BVarterial relative value of liver tumor CTP-BVarterial / liver parenchymal, FD-BV / liver parenchymal FD-BV = FD-BV relative value of liver tumor. Analyze the relationship between the two checks BV values. Results There was a good correlation between the absolute values of CTP-BVarterial and FD-BV (HCC: r = 0.903; liver parenchyma: r = 0.920; P <0.001). The Bland-Altman test showed that the mean difference between CTP-BVarterial and FD-BV relative values was -0.15 ± 0.24. Conclusions FD-BV and CTP-BVarterial values of HCC or liver parenchyma are well comparable, and liver FD-CTP examination is feasible in clinical practice.