实用肝脏病杂志 ›› 2022, Vol. 25 ›› Issue (4): 579-582.doi: 10.3969/j.issn.1672-5069.2022.04.031

• 肝血管瘤 • 上一篇    下一篇

多层螺旋CT增强扫描诊断肝血管瘤与肝转移癌价值分析*

孙向征, 卢微, 李若曼   

  1. 221000 江苏省 徐州市第一人民医院影像中心(孙向征,李若曼);徐州医科大学附属徐州市立医院介入科(卢微)
  • 收稿日期:2021-10-20 出版日期:2022-07-10 发布日期:2022-07-14
  • 通讯作者: 卢微,E-mail:n20141139@163.com
  • 作者简介:孙向征,男,35岁,大学本科,主管技师。E-mail:sxz20211018@126.com
  • 基金资助:
    *徐州市卫生与健康委员会科研项目(编号:XWKYHT20200026)

Differential diagnosis of hepatic hemangioma from liver metastasis by enhanced multi-slice spiral CT

Sun Xiangzheng, Lu Wei, Li Ruoman   

  1. Department of Radiology, First People's Hospital, Xuzhou 221000, Jiangsu Province, China
  • Received:2021-10-20 Online:2022-07-10 Published:2022-07-14

摘要: 目的 探讨多层螺旋CT增强扫描鉴别诊断肝血管瘤(HH)与肝转移癌的价值,为临床准确诊治提供依据。方法 2018年1月~2020年1月我院收治的肝占位性病变患者133例,接受多层螺旋CT增强扫描检查。综合组织病理学和影像学检查诊断,其中HH 102例,肝转移癌31例。结果 HH组肝血流通过时间为(14.3±1.7)s,肝血容量为(25.4±2.6)ml/100 g,毛细血管表面通透性为(33.1±4.6),显著高于肝转移癌组【分别为(9.4±1.0)s、(13.7±1.6)ml/100 g和(27.1±3.1),P<0.05】,而肝动脉灌注为(0.3±0.1)%,肝血流为(151.3±15.9)ml/100g/min,显著低于肝转移癌组【分别为(0.5±0.2)%和(189.3±19.6)ml/100g/min,P<0.05】;HH病灶融合发生率为60.8%,肝包膜下分布为74.5%,靶环征为33.3%,显著高于肝转移癌组(分别为3.2%、0.0%和0.0%,P<0.05),而病灶呈类圆形中心低密度发生率为2.0%,牛眼征为1.0%,显著低于肝转移癌组的61.3%和48.4%(P<0.05);以组织病理学检查结果为金标准,CT增强扫描诊断HH的灵敏度为89.2%,特异度为77.4%,准确度为86.5%,与病理学检查诊断的一致性较好(Kappa值为0.638)。结论 使用多层螺旋CT增强扫描检查诊断HH价值高,可为临床合理地制定处置方案起指导作用。

关键词: 肝血管瘤, 多层螺旋CT, 增强扫描, 诊断

Abstract: Objective The aim of this study was to analyze the differential diagnosis of enhanced multi-slice spiral CT scanning in patients with hepatic hemangioma (HH) and malignant liver metastasis. Methods A total of 133 patients with space occupying lesions inside livers were encountered in our hospital between January 2018 and January 2020, and the comprehensive diagnosis based on imaging and histopathological examination revealed HH in 102 cases and malignant liver metastasis in 31 cases. All patients underwent enhanced multi-slice spiral CT scanning. Results In patients with HH, the blood flow passing time was (14.3±1.7) s, the liver blood volume was (25.4±2.6) ml/100 g, and the capillary surface permeability was (33.1±4.6), significantly higher than [(9.4±1.0)s, (13.7±1.6)ml/100 g and (27.1±3.1), respectively, P<0.05], while the proportion of hepatic artery perfusion was (0.3±0.1)%, and the hepatic blood flow was (151.3±15.9)ml/100g/min, significantly lower than [(0.5±0.2)% and (189.3±19.6)ml/100g/min, respectively, P<0.05] in patients with malignant liver metastasis; the incidences of lesion fusion was 60.8%, the distribution under liver capsules was 74.5%, and the target ring sign was 33.3%, significantly higher than 3.2%, 0.0% and 0.0%, respectively (P<0.05), while the quasi circular central low-density mass was 2.0%, and the bovine eye sign was 1.0%, significantly lower than 61.3% and 48.4%(P<0.05)in patients with malignant liver metastasis; based on the golden criteria, the sensitivity, specificity and accuracy by CT scan in diagnosing HH were 89.2%, 77.4% and 86.5%, with the Kappa of 0.638 consistent with histopathological diagnosis. Conclusion The diagnostic performance of enhanced multi slice spiral CT scanning in patients with HH is efficacious, which might guide the clinicians to make suitable plans for the patients with HH.

Key words: Hepatic hemangioma, Multi-slice spiral CT, Enhanced scan, Diagnosis