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目的 探讨双源双能量CT碘图成像评价肝脏泡状棘球蚴(HAE)病灶供血特点的价值.方法 回顾性分析经手术及病理证实,且术前均行双源双能量CT腹部常规平扫及3期双能量模式增强扫描的18例HAE患者资料,共18个病灶.记录患者不同扫描期相(动脉期、门静脉期和实质期)不同组织结构(包虫组织、病变边缘区域组织及正常肝组织)的碘值,并行病理检查对上述不同组织行微血管密度(MVD)计数.CT扫描不同期相、不同组织碘值的比较采用秩和检验,碘值与MVD的相关性分析采用Spearman法.结果 包虫组织、边缘区域组织和正常肝组织的MVD中位数分别为0.00、25.00和4.00个/高倍视野.动脉期、门静脉期和实质期包虫组织的碘值中位数分别为0.300、0.150和0.150 mg/ml,差异无统计学意义(Z=1.216,P＞0.05);上述期相边缘区域组织的碘值中位数分别为0.350、2.150和2.550 mg/ml,正常肝组织的碘值中位数分别为0.100、1.600和1.900 mg/ml,两者不同期相间碘值差异均有统计学意义(Z值分别为28.800和31.886,P值均＜0.01).相同时相内,不同组织结构间的碘值差异均有统计学意义(P＜0.017).包虫组织、病变边缘区域组织及正常肝组织碘值与MVD计数间呈正相关性(r值为0.775～ 0.958,P值均＜0.01).结论 双源CT双能量成像碘定量技术可较好反映HAE病灶的供血特点.

Objective To explore the value of the dual-source dual-energy CT iodine imaging on blood flow characteristics of liver hydatid(HAE).Methods A retrospective analysis of pre-operative dualsource dual-energy CT including a conventional abdominal scan and 3 phasic scans was performed in 18 patients with surgically and pathologically proven HAE(n=18).The iodine values in different scanning(arterial phase,portal venous phase and parenchymal phase) and different organizational structures(hydatid tissues,normal liver tissues,edge tissue of the lesion and normal liver) were recorded.Pathological examination and micro-vessel density(MVD) count were performed in these different tissues.The iodine results of different phases and different tissues were compared with Rank test.The correlation of iodine value and MVD were performed with Spearman method.Results MVD median of hydatid tissues,regional tissues,edge tissue of the lesion and normal liver were 0.00,25.00 and 4.00/HPF respectively.The median iodine value of hydatid tissues in arterial phase,portal venous phase and parenchymal phase were 0.300,0.150 and 0.150 mg/ml(Z=l.216,P＞0.05) respectively.The median iodine value of edge tissue of the lesion and normal liver in 3 phases were 0.350,2.150 and 2.550 mg/ ml respectively.The median iodine values of normal liver tissues in 3 phases were 0.100,1.600 and 1.900 mg / ml(Z values were 28.800 and 31.886,P＜0.01) respectively.In the same phase of arterial phase,portal venous phase and parenchymal phase,the iodine values showed statistically significant difference(P＜0.05).The iodine values of edge tissue of the lesion and normal liver in 3 phases showed significant difference between the arterial phase and portal venous phase(P＜0.017).The portal venous phase