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目的采用CT灌注成像研究肝细胞癌边缘血流动力学变化和肿瘤发生转移的关系,以探讨预测肝癌发生转移的潜在可能性。方法选择34例经手术病理证实的肝细胞癌患者,术前全部病例进行多层螺旋CT灌注成像,统计瘤周组织的血流灌注指标,并将结果与患者随访情况进行比较分析。结果①肿瘤边缘出现高灌注组发生转移的机会明显高于轻中度灌注组。②肿瘤边缘出现高灌注带组转移发生率明显高于无高灌注带组。③肿瘤边缘高灌注带与镜下血管计数呈正相关。结论可以从肝细胞癌边缘有无异常血流灌注来判断肿瘤是否发生潜在转移。
Objective To study the relationship between hemodynamic changes of hepatocellular carcinoma margin and tumor metastasis by CT perfusion imaging to explore the potential of predicting the metastasis of hepatocellular carcinoma. Methods Thirty-four patients with hepatocellular carcinoma confirmed by surgery and pathology were enrolled in this study. All the cases were examined by multislice spiral CT perfusion imaging before operation. The perfusion indexes of peri-tumor tissue were calculated. The results were compared with the follow-up of the patients. Results ① The chance of metastasis in the high perfusion group at the edge of the tumor was significantly higher than that in the mild and moderate perfusion group. ② The incidence of hyperperfusion in the edge of the tumor was significantly higher than that in the non-hyperperfusion group. (3) There was a positive correlation between tumor perfusion zone and microscopic vascular count. Conclusion Whether the abnormal metastasis of hepatocellular carcinoma can be judged by whether there is abnormal blood perfusion at the edge of hepatocellular carcinoma.