CT灌注成像评价经导管动脉化疗栓塞术治疗原发性肝癌的疗效  

Evaluation of therapeutic effect of transcatheter arterial chemoembolization for primary hepatic carcinoma with CT perfusion imaging

作　　者：邱国钦[1,2] 许丽贞[1,2] 陈玉强[1,2] 刘昌华[1,2] 

机构地区：[1]厦门大学附属成功医院 [2]中国人民解放军第174医院肿瘤中心,福建厦门361003

出　　处：《中国介入影像与治疗学》2013年第12期717-721,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：厦门市科技计划基金资助项目(3502Z20114033)

摘　　要：目的探讨320排CT灌注成像(CTPI)评价TACE治疗原发性肝癌(PHC)疗效的价值。方法对91例中晚期PHC患者于TACE治疗前后行CTPI,对比DSA结果,观察TACE前后肿瘤与正常肝组织的血流灌注参数的变化,评价TACE疗效。结果 CTPI诊断结果与DSA结果相符,诊断符合率为100%,TACE后肿瘤组织的肝血流量(BF)、肝血容量(BV)、肝动脉灌注量(HAP)、肝动脉灌注指数(HPI)均较术前降低(P均<0.05),而平均通过时间(MTT)、毛细血管表面通透性(PS)、门静脉灌注量(PVP)与术前比较差异均无统计学意义(P均>0.05);59例瘤灶碘油沉积不均,灌注图显示存在血流灌注,其残瘤组织的BF、BV、HAP、HPI、PS值均高于正常肝组织(P均<0.05),而MTT、PVP均低于正常肝组织(P均<0.05)。结论 CTPI能全面、直观、定量地反映TACE前后PHC血流动力学变化,对TACE疗效作出客观、准确评价。Objective To explore the value of CT perfusion imaging （CTPI） using 320-row CT scanner in evaluation on the therapeutic effect of TACE for primary liver cancer （PHC）. Methods Totally 91 patients with advanced PHC under- went CTPI before and after TACE. Compared with the result of DSA, blood perfusion changes of tumor and normal liver were observed, and the curative effect of TACE was evaluated. Results CTPI corresponded with DSA, the diagnostic co- incidence rate of CTPI was 100%. Blood flow （BF）, blood volume （BV）, hepatic arterial persusion （HAP） and hepatic perfusion index （HPI） of tumor tissue decreased after TACE （all P〈0.05）, while no statistically significant difference of mean transit time （MTT）, probability of surface area product （PS） nor portal vein perfusion （PVP） of tumor tissue was found before and after TACE （all P〉0.05）. Uneven melanoma focal iodine oil deposits and blood perfusion were showed in 59 case swith residual tumor tissue, with BF, BV, HAP, HPI, PS of residual tumor tissue higher but MTT and PVP lower than those normal hepatic tissue （all P〈0.05）. Conclusion CTPI using 320-row CT scanner can comprehensively, derectly and quantificationally reflect the hemodynamic changes of PHC before and after TACE, therefore objectively and correctly evaluating the effect of TACE.

关 键 词：肝肿瘤 灌注成像 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]