CT灌注参数动脉增强分数值在评估肝癌TACE术后疗效中的初步研究  

Application of quantitative arterial enhancement fraction of multiphase perfusion CT imaging in evaluating the curative effect of transcatheter arterial chemoembolization for hepatocellular carcinoma

作　　者：刘璐璐 章浙伟 杨永波[1] 范林音[1] 邵国良[1] 庞佩佩 

机构地区：[1]浙江省肿瘤医院放射科,杭州310022 [2]浙江省肿瘤医院ge医疗生命科学部

出　　处：《介入放射学杂志》2017年第11期988-992,共5页Journal of Interventional Radiology

基　　金：浙江省医药卫生科技计划项目(2016DTA002、2017200615、2014KYB041);浙江省卫生高层次创新人才培养工程项目(2012-241)

摘　　要：目的探讨常规CT三期灌注参数动脉增强分数(AEF)值在肝细胞肝癌(HCC)行TACE后疗效评价中的应用价值。方法回顾性分析行TACE术的30例HCC患者,于术前1~3 d、术后30~40 d分别行常规CT三期灌注扫描,应用CT Kinetics软件计算AEF参数值。AEF值为(动脉期CT值-平扫期CT值)/(门脉期CT值-平扫期CT值),并将结果进行统计学分析。结果治疗有效组17例,治疗无效组13例。有效组术后AEF为(0.351±0.090),无效组为(0.438±0.050),差异有统计学意义(P<0.05)。以术后AEF值0.392为临界值预测TACE术后疗效,灵敏度和特异度分别为86.7%和73.2%,曲线下面积为0.876(P<0.001)。结论常规CT三期灌注参数AEF能定量反映肝癌TACE前后的血流动力学变化,有助于TACE疗效的早期评价,且不增加格外的辐射剂量。Objective To discuss the application of routine CT three-phase perfusion parameter, that is arterial enhancement fraction （AEF） value, in evaluating the curative effect of transcatheter arterial chemoembolization （TACE） for hepatocellular carcinoma （HCC）. Methods The clinical data of a total of 30 patients with pathologically proved HCC were enrolled in this study. Routine CT three-phase perfusion scan was performed 1-3 days before as well as 30-40 days after TACE in all patients. AEF value was calculated by using CT Kinetics software （GE Healthcare）. The formula for calculating AEF value was as follows： AEF value=（arterial phase CT value-plain scan CT value）＋（portal phase CT value-plain scan CT value）. The results were statistically analyzed. Results Effective treatment group had 17 patients, and ineffective treatment group had 13 patients. The postoperative AEF values in the effective treatment group and the ineffective treatment group were （0.351±0.090） and （0.438±0.050） respectively, the difference between the two groups was statistically significant （P〈0.05）. Taking postoperative AEF value of 0.392 as the critical value to predict the postoperative effect of TACE, the sensitivity and specificity were 86.7% and 73.2% respectively, and the area under the curve was 0.876 （P〈0.001）. Conclusion The routine CT three-phase perfusion parameter （AEF） can quantitatively reflect the hemodynamic changes of HCC after TACE, which is helpful for making early evaluation of TACE effect, meanwhile, no additional radiation dose will be added.

关 键 词：肝细胞肝癌 CT灌注成像 动脉增强分数 经导管动脉化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]