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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(P<0.05)。C组总肝灌注量(TLP)明显高于A组和B组(P<0.05),A、B组间无统计学差异(P>0.05)。三组肝动脉灌注指数(HPI)无明显差异(P>0.05);B组病灶周围组织HAP及HPI明显高于A、C组(P<0.05),A、C组间无统计学差异(P>0.05);三组PVP及TLP差异不显著(P>0.05);三组正常肝脏组织CT灌注参数均无显著差异(P>0.05)。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。
Objective: To investigate the differential diagnosis value of CT in benign liver lesions and liver cancer. Methods: From March 2013 to March 2016, 101 patients with benign liver lesions and liver cancer admitted to our hospital were enrolled in this study. Patients were divided into A, B and C groups according to the type of lesion. A group of 32 patients with primary liver cancer, B group of patients with liver metastases in 28 cases, C group of liver hemangiomas in 41 cases. CT perfusion scanning mode was used to compare the perfusion parameters of the three groups of patients’ lesions, surrounding tissues and normal liver tissues. Results: The HAP in group B was the lowest, group H was the highest in group B, group A was the lowest, group PVP was the lowest, group C was the highest, and group B was better than group B There was a significant difference (P <0.05). The total hepatic perfusion (TLP) of group C was significantly higher than that of group A and group B (P <0.05). There was no significant difference between group A and group B (P> 0.05). There was no significant difference in hepatic artery perfusion index (HPI) between the three groups (P> 0.05). HAP and HPI in the surrounding tissue of group B were significantly higher than those of group A and C (P <0.05) > 0.05). There was no significant difference in PVP and TLP between the three groups (P> 0.05). There was no significant difference in CT perfusion parameters between the three groups (P> 0.05). Conclusion: CT perfusion imaging has some differential diagnostic value for primary liver cancer, hepatic metastases and hepatic hemangiomas, but the definite diagnosis still needs to be combined with other detection methods.