功能CT预评价原发性肝癌介入风险的相关性研究  

Functional CT in predicting the risks of interventional treatment for primary hepatic carcinoma

作　　者：解云川[1] 李玉伟[1] 唐光才[1] 兰永树[1] 戴贵东[1] 

机构地区：[1]泸州医学院附属医院,四川泸州646000

出　　处：《中国临床医学影像杂志》2014年第7期489-492,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨功能CT评价原发性肝癌肝储备功能与介入治疗风险关系的价值。方法:97例CT及实验室检查诊断的原发性肝癌介入治疗前行剩余肝容积测量及肝灌注扫描。治疗后分为肝功能障碍组(n=29)和无肝功能障碍组(n=68)。以介入围手术期相关的影像、介入治疗、实验室指标作为危险因素先行单因素分析,再用P<0.05的指标为自变量行Stepwise Logistic回归分析。结果:单因素分析中两组间差异有统计学意义的有CT测量单位体表面积的剩余肝容积(RHVS)、门静脉灌注量(PVP)、肝血流量(HBF)、肝血容量(HBV)、介入导管的直径、门静脉栓塞、肿瘤直径、术前血清肌酐、凝血酶原活动度、ChildTurcotte-Pugh分级(CTP分级)。Stepwise Logistic回归分析提示肝癌介入术后肝功能障碍的独立危险因素有RHVS减小、PVP降低、介入导管直径增大、术前血清肌酐增高(P<0.01)。结论:功能CT能在介入治疗前评估原发性肝癌的肝储备功能和介入治疗风险并提供影像证据。Objective：To evaluate functional CT in predicting the risks of interventional treatment for primary hepatic carcinoma.Materials and Methods：CT examination and laboratory tests were performed in 97 patients with primary hepatic carcinoma.Before undergoing interventional therapy,remnant hepatic volume measuring and portal perfusion scanning were performed.After interventional therapy,29 patients showed acute hepatic failure （AHF group）,and 68 patients had no hepatic failure （the non-AHF group）.Peri-interventional imaging and experimental vairables were analyzed by analysis of variance and x2 test respectively.The variables of significance （P〈0.05） were analyzed with stepwise logistic regression.Results：Ten variables including remnant hepatic volume per body surface area（RHVS）,protal venous perfusion（PVP）,hepatic blood flow（HBF）,hepatic blood volume（HBV）,diameter of catheter used for embolization,portal venous thrombosis,diameter of tumor,serum creatinine,thrombinogen activity,and Child-turcotte-pugh grading （CTP grading）.The stepwise logistic regression analysis for the variables demonstrated that decreased RHVS,lowering of PVP,bigger diameter of the catheter and high level of serum creatinine were the independent risk factors of acute hepatic failure complicated to interventional therapy for primary hepatic carcinoma（P〈0.01）.Conclusion：Hepatic functional reserve and risks of interventional therapy for primary hepatic carcinoma could be predicted and evaluated by funcional CT.

关 键 词：肝肿瘤 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]