多层螺旋CT增强扫描诊断肝血管瘤的成像特点及其与肝转移瘤的鉴别

肝脏 ›› 2024, Vol. 29 ›› Issue (9): 1074-1076.

多层螺旋CT增强扫描诊断肝血管瘤的成像特点及其与肝转移瘤的鉴别

李炜, 黄世坤, 任道昌, 唐艳,

237300 安徽金寨县中医医院放射科(李炜, 黄世坤, 任道昌);230031 安徽医科大学第一附属医院(唐艳)

收稿日期:2024-06-21 出版日期:2024-09-30 发布日期:2024-11-13
通讯作者: 黄世坤, Email:772965440@qq.com
基金资助:
安徽省重点研究与开发计划(2022e07020033)

Observation on imaging characteristics of multi-slice spiral CT enhanced scanning in the diagnosis of hepatic hemangioma and its differentiation from hepatic metastasis

LI Wei¹, HUANG Shi-kun¹, REN Dao-chang¹, TANG Yan²

1. Department of Radiology, Jinzhai County Traditional Chinese Medicine Hospital, Anhui 237300, China;
2. Anhui Medical University First Affiliated Hospital, Hefei 230031, China

Received:2024-06-21 Online:2024-09-30 Published:2024-11-13
Contact: HUANG Shi-kun, Email:772965440@qq.com

摘要/Abstract

摘要： 目的探讨多层螺旋CT(MSCT)增强成像诊断肝血管瘤(HH)、肝转移瘤的价值。方法收集2022年3月—2024年1月期间诊治的HH、肝转移瘤各82例。按照标准重建算法沿着瘤体边界手动仔细勾画包括平扫期、动脉期、门脉期和延时期在内的瘤体轮廓,自动获取CT增强扫描参数。结果 HH肝血流量、肝血容量、对比剂通过时间、毛细血管表面通透性为(152.4±23.8)mL/(100 g·min)、(22.5±4.7)mL/100 g、(14.2±1.3)s、(33.6±9.2)%,与肝转移瘤[(193.5±31.6)mL/(100 g·min)、(14.1±3.5)mL/100g、(9.3±1.0)s、(27.0±7.9)%]比较,差异具有统计学意义(P<0.05)。82例HH共有病灶116个,其中<10 cm、>10 cm分别为80个、36个。>10 cm HH病灶瘤体容积、瘤体增强容积、动脉期强化比率为(104.2±23.2)mm³、(41.8±9.3)mm³、(41.3±4.6)%,与<10 cm HH[(314.5±72.3)mm³、(53.8±10.9)mm³、(27.1±2.9)%]比较,差异具有统计学意义(P<0.05)。HH病灶融合、肝包膜下分布、靶环征、类圆形中心低密度及牛眼征为43例(52.4%)、60例(73.2%)、23例(28.0%)、3例(3.6%)及1例(1.2%),与肝转移瘤[2例(2.4%)、0(0)、0(0)、51例(62.2%)及37例(45.1%)]比较,差异具有统计学意义(P<0.05)。MSCT结果作为试验组,参照病理学结果为诊断金标准,定义HH、肝转移瘤分别为阳性、阴性结果,MSCT诊断HH敏感度90.2%(74/82)、特异度84.1%(69/82)及准确度87.2%(143/164),与病理学结果的一致性较好(Kappa系数=0.710)。结论以病理学结果作为金标准,MSCT对HH鉴别诊断的一致性较好,表明应用CT增强扫描模式检查能够及时了解HH患者的血供情况,可以较为准确地甄别HH,对指导制定合理的治疗方案有积极的作用。

关键词: 肝血管瘤, 肝转移瘤, 多层螺旋CT

Abstract: Objective To explore the value of multi-slice spiral CT (MSCT) enhanced scanning in the diagnosis of hepatic hemangioma (HH) and hepatic metastasis. Methods Between March 2022 and January 2024, 82 cases of HH and 82 cases of liver metastases were collected. According to the standard reconstruction algorithm, the outline of the tumor including plain scan, arterial phase, portal phase and delayed phase was carefully drawn manually along the boundary of the tumor, and the parameters of enhanced CT scanning were automatically obtained. Results HH hepatic blood flow, hepatic blood volume, contrast agent transit time and capillary surface permeability were (152.4±23.8) mL/(100 g·min), (22.5±4.7) mL/100 g, (14.2±1.3) s, (33.6±9.2)%, compared with liver metastases [(193.5±31.6) mL/100 g/min, (14.1±3.5) mL/100 g, (9.3±1.0) s, (27.0±7.9)%], the difference was statistically significant (P<0.05). There were 116 lesions in 82 cases of HH, of which 80 were <10 cm and 36 were >10cm. It was found that the tumor volume, tumor enhancement volume and arterial phase enhancement ratio of the lesions >10 cm HH [(104.2±23.2) mm³, (41.8±9.3) mm³ and (41.3±4.6) %] had the significant difference (P<0.05) when compared with <10 cm HH [(314.5±72.3) mm³, (53.8±10.9) mm³, (27.1±2.9)%]. The fusion lesions, subcapsular distribution, target ring sign, quasi-circular center low density and bull's eye sign in HH were 43 cases (52.4%), 60 cases (73.2%), 23 cases (28.0%), 3 cases (3.6%) and 1 case (1.2%), compared with liver metastases [2 cases (2.4%), 0(0), 0(0), 51 cases (62.2%) and 37 cases (45.1%)], the difference was statistically significant (P<0.05). The results of MSCT, as the experimental group, were defined as positive and negative results by referring to pathological results. The sensitivity, specificity and accuracy of MSCT in diagnosing HH were 90.2% (74/82), 84.1% (69/82) and 87.2% (143/164), which were in good agreement with pathological results (Kappa coefficient = 0.710). Conclusion Taking pathological results as the gold standard, MSCT has a good consistency in differential diagnosis of HH, which shows that the application of enhanced CT scanning mode can know the blood supply of HH patients in time, and can accurately identify HH, which has a positive effect on guiding the formulation of reasonable treatment plans.

Key words: Hepatic hemangioma, Hepatic metastasis, Multi-slice spiral CT

李炜, 黄世坤, 任道昌, 唐艳,. 多层螺旋CT增强扫描诊断肝血管瘤的成像特点及其与肝转移瘤的鉴别[J]. 肝脏, 2024, 29(9): 1074-1076.

LI Wei, HUANG Shi-kun, REN Dao-chang, TANG Yan. Observation on imaging characteristics of multi-slice spiral CT enhanced scanning in the diagnosis of hepatic hemangioma and its differentiation from hepatic metastasis[J]. Chinese Hepatolgy, 2024, 29(9): 1074-1076.

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