CT增强扫描判断肝血管瘤血供分型及其临床意义

肝脏 ›› 2025, Vol. 30 ›› Issue (4): 476-479.

CT增强扫描判断肝血管瘤血供分型及其临床意义

王旭丽, 周志明, 陈苏闽, 蔡明月

226600 江苏海安市人民医院影像科(王旭丽,陈苏闽),介入科(周志明); 江南大学附属无锡五院影像科(蔡明月)

收稿日期:2024-03-11 出版日期:2025-04-30 发布日期:2025-06-17
基金资助:
江苏省科研基金资助项目(2020F0112)

Application of enhanced CT scanning in diagnosis and blood supply classification of hepatic hemangioma

WANG Xu-li¹, ZHOU Zhi-ming², CHEN Su-min¹, CAI Ming-yue³

1. Department of Image, Hai'an People's Hospital in Nantong, Jiangsu 226600, China;
2. Department of Intervention, Hai'an People's Hospital in Nantong, Jiangsu 226600, China;
3. Department of Image, Wuxi Fifth Affiliated Hospital of Jiangnan University, Jiangsu 214011, China

Received:2024-03-11 Online:2025-04-30 Published:2025-06-17

摘要/Abstract

摘要： 目的探讨CT增强扫描在肝血管瘤(HH)诊断及血供分型判断中的应用价值。方法纳入2018年6月至2023年6月海安市人民医院收治的HH患者62例,CT增强扫描测量动脉期肝固有动脉直径,根据对比剂填充体积、CT表现进行血供分型。比较不同血流灌注HH患者一般资料,观察不同分型的治疗效果。结果在62例HH患者中,CT增强扫描发现高速灌注32例(51.6 %)、中速灌注10例(16.1 %)、低速灌注20例(32.3 %)。高速灌注、中速灌注HH患者肝固有动脉直径比较,差异无统计学意义(P>0.05);高速灌注、中速灌注HH患者肝固有动脉直径分别为(5.1±0.9)mm、(5.0±0.8)mm,高于低速灌注患者的(4.1±0.7)mm(P<0.05)。高速、中速灌注HH患者疗效显著优于低速灌注HH患者(P<0.05)。结论 CT增强扫描在HH诊断及血供分型判断中具有一定的应用价值,高速灌注、中速灌注HH患者血管栓塞治疗效果更好。

关键词: 电子计算机断层扫描, HH, 血供分型

Abstract: Objective To investigate the application value of electronic computed tomography (CT) enhanced scanning in the diagnosis and blood supply classification of hepatic hemangioma. Methods 62 patients with hepatic hemangioma encountered in Haian People's Hospital between June 2018 and June 2023 were subjected to enhanced CT scanning to measure the diameter of the proper hepatic artery during arterial phase, and blood supply classification was performed according to the volume of contrast agent filling and CT manifestations. Observe the CT enhanced scanning of HH patients, compare the general information of HH patients with different blood flow perfusions, observe the CT enhanced scanning of HH patients, and compare the differences in general information of HH patients with different blood flow perfusions. The therapeutic effects of different types were observed. Results Among 62 patients with hepatic hemangioma, enhanced CT scan revealed high speed perfusion in 32 cases (51.6 %), moderate speed perfusion in 10 cases (16.1 %) and low speed perfusion in 20 cases (32.3 %). There was no significant difference in the diameter of the proper hepatic artery between the patients with high speed perfusion and medium speed perfusion (P>0.05). The diameter of hepatic artery was (5.1±0.9) mm and (5.0±0.8) mm, respectively in patients with high speed perfusion and medium speed perfusion, which was significantly higher than that in patients with low speed perfusion [(4.1±0.7) mm, P<0.05].The efficacy of HH patients with high speed and medium speed perfusion was significantly better than that of HH patients with low speed perfusion (P<0.05). Conclusion Enhanced CT scan has a certain application value in the diagnosis of HH and blood supply classification, and the vascular embolization treatment in patients with high speed perfusion and medium speed perfusion HH has a better effect.

Key words: computed tomography, hepatic hemangioma, blood supply classification

王旭丽, 周志明, 陈苏闽, 蔡明月. CT增强扫描判断肝血管瘤血供分型及其临床意义[J]. 肝脏, 2025, 30(4): 476-479.

WANG Xu-li, ZHOU Zhi-ming, CHEN Su-min, CAI Ming-yue. Application of enhanced CT scanning in diagnosis and blood supply classification of hepatic hemangioma[J]. Chinese Hepatolgy, 2025, 30(4): 476-479.

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参考文献

[1] Mamone G, Di Piazza A, Carollo V, et al. Imaging of hepatic hemangioma : from A to Z. Abdom Radiol (NY), 2020, 45(3): 672-691.
[2] Yan C, Li B H, Sun X T, et al. Laparoscopic hepatectomy is superior to open procedures for hepatic hemangioma. Hepatobiliary Pancreat Dis Int, 2021, 20(2):142-146.
[3] Jia K, Gao Z, Li M, et al. Interventional treatments for hepatic hemangioma:a state-of-the-art review. J Interv Med, 2022, 5(1): 6-9.
[4] Fang L, Huang B J, Ding H, et al. Contrast-enhanced ultrasound (CEUS) for the diagnosis of hypoechoic hepatic hemangioma in clinical practice. Clin Hemorheol Microcirc, 2019, 72(4): 395-405.
[5] 高莉, 高屹, 尹秋萍. CT灌注成像联合彩色多普勒超声造影辨别肝脏结节性病变性质临床价值探讨. 实用肝脏病杂志, 2020, 23(1): 106-109.
[6] 国际肝胆胰协会中国分会HH专业委员会. HH诊断和治疗多学科专家共识(2019版). 中华消化外科杂志, 2019, 18(8): 705-710.
[7] Fard-Esfahani A , Fallahi B , Khatami K ,et al.Agreement of two methods of planar and SPECT scintigraphy with 99mTc- RBC in detection of liver hemangioma.Iranian Journal of Nuclear Medicine, 2006, 14(26):26+8-12.
[8] Ozaki K, Yoshikawa J, Yamamoto T, et al. Preoperative diagnosis of the sclerosed hemangioma of the liver using multimodality imaging findings: a case report. Radiol Case Rep, 2018, 13(5): 1025-1029.
[9] Dong W, Qiu B, Xu H, et al. Invasive management of symptomatic hepatic hemangioma. Eur J Gastroenterol Hepatol, 2019, 31(9): 1079-1084.
[10] Zerpa R, Abdelghani E H, Iliescu G, et al. Enormous haemangioma of the liver. BMJ Case Rep, 2019, 12(3): e226983.
[11] 唐文涛, 黄会, 蔡婵娟. 平阳霉素联合超化碘油混悬液经动脉介入栓塞治疗HH患者中远期疗效研究. 实用肝脏病杂志, 2021, 24(4): 581-584.
[12] Liu Q, Liu F, Ding J, et al. Surgical outcomes and quality of life between laparoscopic and open approach for hepatic hemangioma: a propensity score matching analysis. Medicine (Baltimore), 2019, 98(6): e14485.
[13] 王娇,贾科峰,于长路,等. 肝血管瘤CT增强诊断分型与肝固有动脉直径相关性研究[J]. 介入放射学杂志,2023,32(4):376-380.
[14] 孙向征, 卢微, 李若曼. 多层螺旋CT增强扫描诊断HH与肝转移癌价值分析. 实用肝脏病杂志, 2022, 25(4): 579-582.
[15] Klein M, Chang A K, Vasudevan S A, et al. Clinically significant ascites as an indication for resection of rapidly involuting congenital hepatic hemangiomas. Pediatr Blood Cancer, 2018, 65(8): e27222.
[16] Wu X F, Bai X M, Yang W, et al. Differentiation of atypical hepatic hemangioma from liver metastases: diagnostic performance of a novel type of color contrast enhanced ultrasound. World J Gastroenterol, 2020, 26(9): 960-972.
[17] Li W, Li R, Zhao X, et al. Differentiation of hepatocellular carcinoma from hepatic hemangioma and focal nodular hyperplasia using computed tomographic spectral imaging. J Clin Transl Hepatol, 2021, 9(3): 315-323.