双源CT灌注成像在肝转移瘤TACE前后的临床应用研究  

Clinical study of dual-source CT perfusion imaging in liver metastases before and after treatment of TACE

作　　者：贾彦斌[1] 王书行[1] 齐晓辉[2] 刘晶[2] 王炜娜[1] 时高峰[2] 

机构地区：[1]河北省石家庄市第三医院CTMRI科,河北石家庄050011 [2]河北医科大学第四医院CT室,河北石家庄050011

出　　处：《河北医科大学学报》2016年第4期427-430,共4页Journal of Hebei Medical University

摘　　要：目的通过双源CT灌注成像观察肝转移瘤的血流动力学特征、肝动脉栓塞化疗（transcatheter hepatic arterial chemoembolization,TACE）后肝转移瘤灌注参数特征和改变,以及双源CT灌注成像评价TACE的效果。方法应用第二代西门子双源CT对28例肝转移瘤患者在TACE前和TACE后25～35d行CT灌注扫描检查。测量治疗前后肝转移瘤和周围正常肝实质的CT灌注参数。结果 TACE前肝转移瘤CT灌注参数肝动脉灌注量（hepatic arterial perfusion,ALP）、肝动脉灌注指数（hepatic perfusion index,HPI）、门静脉灌注量（portal vein perfusion,PVP）均大于周围正常肝实质,血流量（blood flow,BF）、血容量（blood volumn,BV）、表面通透性（permeability surface,PMB）均小于周围正常肝实质（P〈0.05）。TACE后肝转移瘤CT灌注参数BF、BV、PMB、ALP均较TACE前减低,PVP、HPI均较TACE前增高（P〈0.05）;TACE后肝转移瘤PVP、HPI均大于周围正常肝实质,BF、BV、PMB、ALP均小于周围正常肝实质（P〈0.05）。结论第二代双源CT灌注成像能够客观反映肝转移瘤的血流动力学特征,并能够评价TACE前后肝转移瘤的血供变化,为临床治疗提供有价值的指导。Objective To study the application of dual-source CT perfusion imaging in evaluating the effect of transcatheter hepatic arterial chemoembolization（TACE）of liver Metastases,by analyzing the parameter of hemodynamic characteristic before and after TACE.Methods 28 patients with hepatic metastases were included in the study.All the patients were underwent duai-source CT perfusion imaging scans before and after TACE（range from 25-35d）.The CT perfusion parameters of liver metastases and surrounding normal liver parenchyma before and after TACE were measured.Results Before TACE the hepatic arterial perfusion（ALP）,hepatic perfusion index（HPI）,portal vein perfusion（PVP）of the liver metastases were higher than that of surrounding normal liver parenchyma,while the blood flow（BF）,blood volume（BV）,permeability surface（PMB）were lower（P〈0.05）.After TACE the BF,BV,PM,ALP of liver metastases were lower than that of before TACE,and the PVP,HPI of liver metastases were higher than that of before TACE（P〈0.05）.After TACE,the PVP,HPI of liver metastases were higher than that of surrounding normal liver parenchyma,while the BF,BV,PMB,ALP were lower（P〈0.05）.Conclusion Dual-source CT perfusion imaging can objectively reflect the hemodynamic characteristics of liver metastases,and evaluate the blood supply of liver metastases before and after hepatic artery embolism chemotherapy,providing valuable guidance for clinical treatment.

关 键 词：肝肿瘤 化学疗法 肿瘤 局部灌注 体层摄影术 螺旋计算机 

分 类 号：R735.7[医药卫生—肿瘤]