原发性肝癌首次TACE术后CT灌注与MRI的研究初探  

Preliminary Study of CT Perfusion and MRI of Hepatocelluar Carcinoma after Fist Transcatheter Chemoem-Bolization with Lipiodol

作　　者：赵立峰[1] 王昌生[2] 张妍芬[3] 刘磊[3] 陆平[1] 徐克[3] 

机构地区：[1]齐齐哈尔医学院附属第五医院放射科,黑龙江大庆163453 [2]大庆油田总医院集团乘风医院放射科,黑龙江大庆163411 [3]中国医科大学附属第一医院放射科,辽宁沈阳110001

出　　处：《中国误诊学杂志》2009年第16期3783-3785,共3页Chinese Journal of Misdiagnostics

摘　　要：目的:探讨分析CT灌注和MRI平扫评价原发性肝癌TACE术后肿瘤残留的能力。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DSA检查前行CT灌注和MRI平扫。以DSA结果为标准,分析比较CT灌注和MRI平扫对肿瘤残存的显示和确认情况。结果:以DSA为标准,CT灌注、MRI平扫的敏感性分别为96.6%、72.4%,特异性为10.0%、95.0%,准确性为61.2%、81.6%。结论:CT灌注对判断TACE术后病灶肿瘤组织残留较MRI平扫敏感,但准确性较差,不宜临床应用,考虑与化疗药物缓释及栓塞物刺激引起的炎性反应有关。Objective：TO make a preliminary study of the ability of CT-perfusion and MRI in the evaluating the residual of tumor of hepatocellular carcinoma （HCC） and the stability after first treated by transcatheter arterial ehemoembolization （TACE） with Lipiodol. Method：30 patients with HCC underwent CT-perfusion,MRI and angiography after first procedure （s） of TACE. These three examinations were completed sequentially within one week. CT-perfusion and MRI findings were compared on the basis of the results of angiography. Results ： 49 lesions were found in 30 patients. 29 lesions with and the other 20 lesions without residual viable tumor were confirmed by angiography. 46 lesions with and the other 3 lesions without residual viable tumor were found on CT-perfusion images,and CT-perfusion displayed 96.6% sensitivity, 10. 0% specificity,and 61.2% accuracy respectively. The accuracy between CT-perfusion and DSA in evaluating the residual viable tumor of HCC after first TACE was significant different （P〈0. 01） ;22 lesions with and the other 27 lesions without residual viable tumor were found on MRI images ,and its sensitivity,specificity,and accuracy were, 72.4%, 95.0% and 81.6% respectively, the accuracy between MRI and DSA in evaluating the residual viable tumor of HCC after first TACE were different （P〈0. 05） ;the sensitivity between CT-perfusion and MRI in evaluating the residual viable tumor of HCC after first TACE were different （P^0.05）,accuracy were different（P〈0.05）. Conclusion：It＇s unsuitable to evaluate viable tumor residua 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 first TACE more than MRI.

关 键 词：肝肿瘤/外科学/放射摄影术 体层摄影术 X线计算机 磁共振成像 手术后期间 人类 

分 类 号：R735.7[医药卫生—肿瘤]