超声、CT、MRI及DSA在肝癌介入综合治疗术后肿瘤活性评估中的对比价值研究  

The clinical value of ultrasound, CT, MRI and DSA in evaluating the activity of residual HCC lesions after interventional comprehensive therapy: a comparative study

作　　者：徐民[1] 程雪[1] 赵中伟[1] 宋晶晶[1] 杨伟斌[1] 吴徐璐 陈敏江 程星遥 范晓希[1] 刘丽霞 纪建松[1] XU Min, CHENG Xue, ZHAO Zhongwei, SONG JinXing, YANG Weibin, WU Xulu, CHEN Minjiang, CHENG Xingyao, FAN Xiaoxi, LIU Lixia, Jl Jiansong(Imaging Diagnosis and lnterventional Minimally-Invasive Center, Lishui Hospital of Zhejiang University, Affiliated Fifth Hospital of Wenzhou Medical University, Lishui, Zhejiang Province 323000, Chin)

机构地区：[1]浙江大学丽水医院、温州医科大学附属五院影像诊断与介入微创中心、浙江省影像诊断与介入微创研究重点实验室,浙江丽水323000

出　　处：《介入放射学杂志》2018年第4期363-366,共4页Journal of Interventional Radiology

基　　金：浙江省重大科技专项重大社会发展项目(2013C03010)、浙江省医药卫生科学研究基金(2017KY724)、丽水市公益性技术应用研究计划项目(2016GYX37、2016GYX36)、浙江省实验动物科技计划项目(2017C37178、2016C37101)、浙江省自然科学基金青年基金(Q17H180002)、国家卫生计生委省部共建项目(WKJ-ZJ-1629)、国家自然科学基金面上项目(81573657)、浙江省中医药科研基金(2016ZA209、2016ZA210)、丽水市科技自筹项目(2015sjz

摘　　要：目的探讨超声(US)、CT、MRI及DSA在评估肝癌介入综合治疗术后肿瘤活性的价值。方法回顾性收集本院2011年2月—2014年10月63例75个病灶经病理或临床治疗确诊的肝癌患者的临床资料,所有患者经介入综合治疗后3~5周后均行US、CT、MRI检查,并再次行DSA进行诊疗,以DSA造影检查阳性结果为金标准,再对各检查结果进行对照、分析。结果 63例75个病灶经介入综合治疗后3~5周后均行US、CT、MRI及DSA检查,其中有25个病灶经DSA证实活性病灶;US病灶检出74个(98.7%),25例活性病灶检出12个(48.0%);CT增强病灶检出75个(100%),活性病灶检出18个(72.0%);MRI病灶检出率75个(100.0%),活性病灶检出率22(88.0%);US、CT、MRI三者联合,病灶检出75个,活性病灶检出24(96.0%)。结论 MRI在肝癌介入综合治疗术后肿瘤活性评估中的价值明显优于US、CT。三者联合可以互补,可以帮助更多地了解关于病灶的信息,有助于后续治疗方案的制定及疗效的评估。Objective To assess the clinical value of ultrasound （US）, CT, MRI and digital subtraction angiography （DSA） in evaluating the activity of residual hepatocellular carcinoma （HCC） lesions after interventional comprehensive therapy. Methods The clinical data of 63 patients with pathologically or clinically proved HCC （75 lesions in total）, who were admitted to authors＇ hospital during the period from February 2011 to October 2014 to receive interventional therapy, were retrospectively analyzed. US, CT and MRI were performed in all patients at 3-5 weeks after interventional comprehensive therapy, and DSA was again carried out for further check-up. Taking the positive results of DSA as the gold standard, the results of US, CT and MRI examinations were compared and analyzed. Results All the 63 patients （75 lesions in total） underwent US, CT, MRI and DSA examinations at 3-5 weeks after interventional comprehensive therapy. Among the 75 lesions, 25 were confirmed to be active lesions by DSA. US revealed 74 lesions （74/75, 98.7%）, and detected 12 active lesions （12/25, 48.0%）. Contrast-enhanced CT scan demonstrated 75 lesions （75/75, 100%）, and checked out 18 active lesions（18/25, 72.0%）. MRI displayed 75 lesions （75/75, 100%）, and found out 22 active lesions （22/25, 88.0%）. The combination of US, CT and MRI detected 75 lesions, including 24 （24/25, 96.0%） active lesions. Conclusion MRI is obviously superior to US and CT in evaluating the activity of residual HCC lesions after interventional comprehensive therapy. Combination use of US, CT and MRI can help obtain more information about the lesions, which is very valuable for making follow-up treatment plan and evaluating the curative effectiveness.

关 键 词：超声检查 体层摄影术 磁共振 肝癌 介入治疗 

分 类 号：R735.7[医药卫生—肿瘤]