【摘要】 目的探讨CT灌注参数与微血管密度(MVD)对肝脏良恶性病变的诊断价值。方法选取我院经手术病理证实诊断并行CT灌注成像(CTP)的28例肝脏占位性病变,于手术切除标本上取材,行免疫组化微血管染色,并对灌注参数与MVD进行定量分析。结果肝脏恶性病变交界区与背景肝组织比较,MVD、肝动脉灌注量(HAP)均有显著性差异(P<0.05);肝脏恶性病变交界区与正常背景肝组织比较,门静脉灌注量PVP有显著性差异(P<0.001)。Spearman等级相关分析:肝硬化肝癌交界区、恶性肿瘤病变交界区及良性病变交界区MVD与HAP均呈明显正相关(r=0.550,P<0.05;r=0.585,P<0.05;r=0.478,P<0.05)。16例肝脏恶性病变中,15例病变交界区HAP、PVP及MVD与背景正常肝组织有明显差异,仅1例肝癌(有假包膜)病变交界区HAP、PVP及MVD与背景肝组织相近。12例肝脏良性病变交界区HAP、PVP及MVD均与背景肝组织相近。结论 CT灌注参数和MVD对鉴别肝脏良恶性病变有重要意义,HAP能间接反映MVD情况,提高术前对恶性肿瘤相关血管的认识。更多还原

【Abstract】 Objective To study the diagnosis value of perfusion parameters and microvessel density(MVD) on hepatic benign and malignant lesions.Methods Twenty-eight patients with liver benign and malignant lesions confirmed by pathology were enrolled and underwent CTP.The tissues were collected from surgical resection specimens and stained by microvessels immunohistochemistry.Perfusion parameters and MVD were quantitatively analyzed.Results The junction area of malignant lesions was compared with the background liver tissue: MVD and HAP were significantly different(P<0.05);PVP(non cirrhotic background) was significantly different(P<0.001).Spearman rank correlation analysis: The junction area of liver cancers(cirrhotic background),MVD of the junction area of malignant lesions(non-cirrhotic background) and the junction area of benign lesions were all positively correlated with HAP(r=0.550,P<0.05;r=0.585,P<0.05;r=0.478,P<0.05).In 16 malignant lesions,HAP,PVP and MVD of the junction area of 15 lesions were significantly different,when compared with the background liver tissue.Only HAP,PVP and MVD of the junction area of 1 liver cancer were similar to the background liver tissue.Conclusion The difference of MVD and perfusion parameters are meaningful in the differential diagnosis of hepatic benign and malignant lesions.HAP can indirectly reflect the situation of MVD and serve as a good index for a better understanding of cancer-related artery before surgery.更多还原