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目的:用肝血池三维(3D)立体图像,判定肝占位病变的性质。方法:对45例肝占位病变患者,做肝核素显像检查,并建立三维立体图像,判定其性质;再与肝血流灌注相的早期充盈、时间活性曲线(TAC)、肝血池(平面及断层)显像、CT和彩超检查作对照。结果:28例肝血管瘤:肝血池3D立体图像确诊27例,平面图像确诊22例,断层图像确诊24例,均显示过度充填;27例TAC高峰左移,高度增加;CT确诊23例,彩超24例。8例肝癌:肝血池3D立体图像确诊6例,平面图像确诊5例,断层图像确诊6例,充填为阴性;肝血流灌注相均有早期充盈,TAC高峰右移;CT及彩超确诊6例。肝良性病变(囊肿6例,实质性病变3例):3D立体图像、平面、断层图像充填阴性7例(囊肿4例,实质性病变3例);肝血流灌注相均无早期充盈,TAC呈持续低下曲线;彩超确诊7例(囊肿6例,实质性病变1例);CT确诊7例(囊肿5例,实质性病变2例)。结论:肝血池3D立体图像,对肝血管瘤诊断灵敏度高;肝血流灌注相早期充盈、TAC高峰变化,对判定肝占位病变的良恶性有十分重要的意义。
Objective: To determine the nature of hepatic space occupying lesions by using three-dimensional (3D) stereoscopic images of hepatic blood pool. Methods: Forty-five patients with hepatic lesions were examined with hematoxylin and three-dimensional stereoscopic images to determine the nature of the hepatic tumor. The early filling, time-activity curve (TAC), hepatic blood pool (Plane and tomography) imaging, CT and color Doppler ultrasound examination for control. Results: Twenty-eight hepatic hemangiomas were diagnosed in 23 liver biopsy samples by Twenty-three stereoscopic images, 22 were confirmed by planar images and 24 were confirmed by tomographic images. Color ultrasound in 24 cases. 8 cases of liver cancer: 3 cases of liver blood pool were diagnosed by 3D stereoscopic images in 6 cases, 5 cases were confirmed by plain images, 6 cases were confirmed by tomographic images, and the filling was negative. The hepatic perfusion phase was filled early and the TAC peak shifted to the right. example. Liver benign lesions (cysts in 6 cases, 3 cases of parenchymal lesions): 3D stereotactic images, 7 cases of negative images of planar and tomographic images (4 cases of cysts and 3 cases of parenchymal lesions); no hepatic perfusion phase of early filling, TAC 7 cases were diagnosed by color Doppler ultrasonography (cysts in 6 cases, 1 case of parenchymal lesions); 7 cases were diagnosed by CT (5 cases of cysts and 2 cases of parenchymal lesions). Conclusion: The stereoscopic 3D image of liver blood pool has high diagnostic sensitivity to hepatic hemangiomas. Filling hepatic perfusion phase with early filling and peak TAC changes is of great significance in judging the benign and malignant lesions of hepatic space.