CT灌注诊断原发性肝癌TACE术后局部肿瘤生长的研究  

A preliminary study of CT perfusion to evaluate tumor residual of hepatocelluar carcinoma after transcatheter chemoembolization

作　　者：赵立峰[1] 徐克[2] 苏洪英[2] 张妍芬[2] 任克[2] 黄崑[2] 高飞[2] 

机构地区：[1]齐齐哈尔医学院附属第五医院(大庆油田总医院集团龙南医院)放射科,黑龙江大庆163453 [2]中国医科大学附属第一医院放射科,辽宁沈阳110001

出　　处：《现代肿瘤医学》2009年第1期79-82,共4页Journal of Modern Oncology

摘　　要：目的:探讨CT灌注评价原发性肝癌TACE治疗后病灶局部肿瘤生长的能力。方法:选择TACE治疗后CT平扫不能明确有无局部肿瘤生长的病例30例,行CT灌注和DSA检查。以术后1个月为界分成2组,以DSA结果为标准,分析CT灌注对局部肿瘤生长的显示和确认情况。结果:A、B组:CT灌注的敏感性为90.9%、80.0%,特异性为6.7%、71.4%,准确性为40.7%、77.3%。结论:CT灌注对判断TACE术后病灶的局部肿瘤生长有较好的敏感性,术后1个月内不宜应用CT灌注;2个月后可以应用CT灌注进一步判断。Objective：To study the value of CT - perfusion in evaluating the tumor residual of hepatocellular carcinoma （HCC） after treated by transcatheter arterial chemo -embolization （TACE） with Lipiodol. Methods： Tthirty patients with HCC were performed with CT- perfusion and angiography within 1 -2 months after 1 -4 procedure of TACE. These two examinations were completed sequentially within one week. CT - perfusion findings were evaluated on the basis of the results of angiography. Results：Total of 52 lesions were found in 30 patients, 27 were found af- ter 1 month of TACE and the rest after 2 months. All lesions had obvious iodine sedimentation. Among the 27 lesions, 11 lesions with and the other 16 without viable tumor residual were confirmed by angiography, 25 lesions with and the other 2 without viable tumor residual were found on CT - perfusion images, so CT - perfusion dis- played 90.9% sensitivity ,6.7% specificity and 40.7% accuracy. In the followed several months, 15 lesions with and the other 7 without viable tumor residual were confirmed by angiography, and 14 lesions with and the other 8 without were found on CT - perfusion images. It showed that CT - perfusion had 80.0% sensitivity, 71.4 % specificity and 77.3 % accuracy after 2 months. CT - perfusion and angiography had significant differentiation in evaluating the viable tumor residual of HCC after 1 month of TACE （ P 〈 0.01 ）. But during the followed several months, the two had no obvious diversity （P 〈0.01 ）. Therefore,between the two groups, difference only existed in accuracy（ P 〈 0.01 ） but not in sensitivity（ P 〉 0.05 ）. Conclusion ： CT- perfusion is unsuitable to e- valuate viable tumor residual by CT - perfusion for a patient who dose further consultation first time just after 1 month of TACE because of inflammatory reactions. Even though it is sensitive to assess the residual tumor tissues after TA- CE. After 2 months of TACE, it＇s feasible to take CT - perfusion for more assessment of tumor residual if

关 键 词：肝细胞癌 断层摄影 x线计算机 血流灌注 动脉造影 介入放射学 

分 类 号：R735.7[医药卫生—肿瘤]