Carcinoma Of The Ct Perfusion Study

The Study of CT Perfusion of 11CCAbstractPurposes:(1) To search for a reliable way of liver CT perfusion and to improve the hepatic arterial perfusion calculation and to deduce an equation to calculate portal perfusion of liver. @) To quantify and compare the hepatic arterial and portal venous perfusion of hepatocellular carcinoma (HCC), perituxxior liver and liver in control group. ?To explore the correlation of the perfusion of HCC with its pathologic grade and microvessel density (MVD).Materials and methods: Eighty-four patients were studied, consisting of sixty-one cases of HCC (59 male, 2 female, mean age 46 years) and twenty-three controls (17 male, 6 female, mean age 41 years). After plain CT scan of the whole liver, a single slice through the center of the lesion or through the portal hepatis was repeatedly scanned for 41 .25s?2s after intravenous bolus injection of 30-40 ml nonionic contrast media at 4.$-6.7m1/s.Time-density curves (TDCs) of aorta, hepatic artery, portal vein, liver and spleen were analyzed. Hepatic arterial perfusion (HAP) was calculated by dividing the peak gradient of the liver TDC before the splenic peak by the peak hepatic arterial enhancement. Hepatic portal perfusion (HPP) was calculated by dividing the peak gradient of the portal TDC by the peak portal vein enhancement. Hepatic arterial perfusion was determined in 140 (61 of HCC, 56 of peritumor and 23 of control group) and portal venous perfusion in 128 (54 of HCC, 51 of peritumor and 23 of control group). HAP plus 1{PP was the total liver perfusion (TLP). HAl was obtained by dividing HAP by TLP, and PPI bydividing HPP by ThP.Results:①The mean HAP, HPP, TLP, HAl and PPI of liver in control group were 0.399mIIminIml, 1.143 mI/mm/mi, 1.543 mi/mm/mI, 0.26, 0.74IIrespectively. ?The data of the peritumor liver were 0.378 mI/mm/mi, 1.112 mI/mm/mi, 1.489 mlImin/mL, 0.25, 0.75 respectively. There were no statistic difference in contrast to those of the control group. ?The data of the HCC were 0.784 mI/mm/mi, 0.441 mI/mm/mi, 1.225 mi/mm/mI, 0.64, 0.36 respectively, all were markedly different from those of the control liver and the peritumor liver (P<0.01) . (~) MVD of high-, mid- and low-differentiated HCC was 73.6, 166.7, 238.2 per mm2 respectively, and the mean HAP, HPP, TLP, HAl and PPI of the three subgroup was 0.478 mllminlml, 0.441 mI/mm/mi, 0.918 mI/mm/mi, 0.52, 0.48 and 1.216 mI/mm/mi, 0.587 mI/mm/mi,1.803mI/mm/mi, 0.67, 0.33 and 1.103 mi/mm/mI, 0.473 mi/mm/mI, 1.576 mi/milL/mi, 0.71, 0.29 respectively. That showed, high- differentiated HCC had lowest MVD, HAP, HPP, TLP, HAl and highest PPI in the three, and mid- one had highest MVD, HPP, ThP, while low- one HCC had highest MVD, HAl and lowestPPl (NO.05, 0.01)Conclusions:1.The CT perfusion method in our study is obtained by improving the method described in the literature and review, with more accurate TDC and simpler portal perfusion calculation.2.The HAP, HAl increase markedly in HCC, while HPP, PPI markedly decrease in contrast to the control liver. So the calculating of perfusion data will be helpful for the diagnosis of HCC and acknowledging its hemodynamic changes.3.The perfusion data correlates with MVD and the pathologic grade in the HCC group, thus perfusion CT offers a new way to study the MVD and judge the pathologic grade of HCC in vivo, which will be helpful to best the treatment protocol and to foretell the patient抯 prognosis.