超微细血流成像技术评价肝癌介入治疗疗效的价值  

The Value of SMI in the Evaluation of interventional therapy of liver cancer

作　　者：刘水清[1] 马一博[1] 韩宗宏[2] 谢潇[1] 王草叶[2] 陶源[3] 陈卉[1] 刘艳萍[1] 

机构地区：[1]苏州大学附属第三医院超声科,常州213003 [2]苏州大学附属第三医院肿瘤介入科,常州213003 [3]苏州大学附属第三医院统计科,常州213003

出　　处：《中华肝脏病杂志》2017年第7期512-516,共5页Chinese Journal of Hepatology

摘　　要：目的探讨超微细彩色血管成像（SMI）技术评价肝癌介入治疗疗效的临床应用价值。方法选取30例肝肿瘤患者共40个病灶，均经肝穿刺病理学证实，在给予肝动脉化疗栓塞术（TACE）后1个月，分析彩色多普勒血流成像（CDFI）、SMI及增强CT的影像学差异，并以增强CT作为金标准，比较同一病灶的血供情况。数据采用经过连续性校正的McNemar配对x^2检验，以P〈0．05为标准比较CDFI技术与SMI技术显示瘤体内部与周边血流信号能力的差异。结果30例肝癌患者，原发性肝癌12例（合并肝硬化7例），转移性肝癌18例；共40个瘤体，单发25例，多发5例（15个病灶）。CDFI与SMI在显示肝癌介入治疗后病灶内部残留细微血管的能力差异有统计学意义（x^2=16．9615，P〈0．01），SMI显示病灶内部血流信号的能力与增强CT间差异有统计学意义（x^2=8．6429，P〈0．05），SMI显示病灶周边血流信号的能力与增强CT间差异无统计学意义（x^2=2．2857，P〉0．05）。CDFI显示肝癌病灶内部与周边血流信号的灵敏度与SMI显示肝癌病灶内部与周边血流信号的灵敏度分别为29．40％、67．60％和61．80％、82．30％，特异度分别为66．70％、66．70％和83．30％、83．30％，正确指数分别为35．00％、67．50％和65．00％、82．50％。结论SMI技术是一种新型的血流成像技术，可检测到肝癌病灶内部与周边细微的血流信号，明显优于CDFI，达到与增强CT相近似的效果，为临床评估肝癌TACE术后疗效提供了一种新的方法。Objective To evaluate the value of super microvascular imaging（SMI） for evaluating the effect of interventional therapy of liver cancer. Methods A total of 30 patients with 40 leisions were enrolled in this study, from the tumor intervention department in the third affiliated hospital of suzhou university.This patients were underwent TACE, after the treatment 1 month, CDFI, SMI, and CT were study respectively. Using the continuity correction McNemar matching chi-square test, with P 〈 0.05 for the standard, CDFI and SMI shows the difference in monitoring the microvascular imaging in and around the tumors leisions. Results A total of 30 patients, 12 cases were primary liver cancer （7 cases combined with liver cirrhosis）, 18cases were metastatic liver cancer; 30 cases including 25 single and 5 multiple. Significant difference were found between CT and SMI in detecting blood flows inside the lesion （x^2 = 8.642 9, P 〈 0.05）, and were also found between CT and CDFI in detecting blood flows inside the lesion （x^2 = 16.961 5, P 〈 0.05）. The AUROC, sensitivity, specificity, accuracy, PPV and NPV of CDFI were 0.647, 29.4%, 100%, 29.4%, 100%, 20.0%, while in SMI were 0.809, 61.8%, 100%, 61.7%, 100%, 31.5%, respectively. Conelusions SMI SMI can detect the microvascular inside the lesions. This new method was superior to CDFI, achieving the same effect as CT.

关 键 词：肝肿瘤 超细微彩色血流成像 彩色多普勒超声检查 肝动脉化疗栓塞术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]