双源CT全肝灌注成像用于原发性肝细胞癌患者动脉导管化疗栓塞术后疗效评估研究  

Value of dual-source CT whole liver perfusion imaging in evaluation of curative effect of TACE after primary HCC

作　　者：喻朋辉[1] 赵香田[2] YU Peng-hui;ZHAO Xiang-tian(Department of Radiology,Zhengzhou people＇s Hospital（Zhengzhou Henan,450003）China)

机构地区：[1]郑州人民医院影像科,河南郑州450003 [2]郑州大学第一附属医院磁共振室

出　　处：《中西医结合肝病杂志》2018年第5期307-309,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：河南省郑州市医学科学基金(No.20170241)

摘　　要：目的:分析双源CT全肝灌注成像在原发性肝细胞肝癌(HCC)患者动脉导管化疗栓塞术(TACE)术后评估中的意义。方法:根据本研究相关标准,于2016年3月~2017年5月共纳入行TACE术治疗的HCC患者30例,均为中晚期患者。在TACE术前1~2d进行双源CT平扫,在术后3~5d和术后1个月再行双源CT三期增强扫描和全肝灌注扫描,注射非离子型碘对比剂和生理盐水,获取动脉扫描,获取术前和术后1个月灌注伪彩图。对比术前碘油完全沉积区与术后栓塞区灌注参数肝动脉灌注指数(HPI)、门静脉灌注量(PVP)、肝动脉灌注量(ALP)、开始时间(TTS)、血容量(BV);对比术前术后碘油沉积区灌注参数HPI、PVP、ALP、TTS;对比参与术前术后残余病灶灌注参数,及术后残余病灶与碘油沉积区灌注参数。结果:(1)术后栓塞区与术前碘油完全沉积区(原发病灶) HPI降低,PVP、TTS升高,ALP、BV降低。P均<0. 05;(2)术后碘油沉积区与术前碘油沉积区相比,HPI、ALP降低,PVP、TTS升高,P均<0. 05;(3)术后残余病灶区与术前对比,HPI升高,PVP降低,P均<0. 05,ALP、TTS不变,P> 0. 05。(4)与术后碘油沉积区对比,术后残余病灶HPI较高,PVP较低,ALP较高,TTS较低,P均<0. 05。结论:双源CT全肝灌注成像能评估患者动脉导管化疗栓塞术治疗效果,监测参与病灶。Objective：To analyze the significance of dual-source CT whale liver perfusion imaging in postoperative evaluation of transcatheter arterial chemoembolization （TACE）in patients with primary hepatocellular carcinoma （HCC）. Methods：According to the relevant criteria of this study,30 patients with primary HCC treated with TACE were enrolled from March 2016 to May 2017,both of whom were advanced stage patients. Dual-source CT scan was performed 1 - 2 days prior to TACE, and double-source CT three-phase enhanced scan and whole liver perfusion scan were performed 3-5 days after operation and 1 month after operation. Non-ionic iodine contrast agent and physiological Saline, arterial scan was obtained, preoperative and postoperative 1 month perfusion pseudo-color map. Comparing the complete deposition area of lipiodol in patients with HCC before and after thrombosis ,the parameters of hepatic artery perfusion index （HPI） ,portal vein perfusion （ PVP）, hepatic artery perfusion （ ALP）, start time （ TTS）, blood volume BV）. The perfusion parameters of HPI, PVP, ALP and tITS in the lipiodol deposition area were compared before and after TACE. The perfusion parameters of residual lesion and postoperative residual lesion and lipiod deposition area were compared. Results： （1） After operation, the HPI, PVP, ALP, TTS and BV were decreased in the complete deposition zone （ primary lesion） and in the complete deposition zone （ primary lesion）. （P 〈 0.05 respectively）. （2） Compared with preoperative lipiodol deposition area, HPI, PVP increased, ALP decreased, TTS increased, （ P 〈 0.05 ） ; In contrast, HPI increased, PVP decreased, （ P 〈 0.05 ）, while ALP and TTS unchanged（P 〉 0.05）. （4） Compared with postoperative lipiodol deposition area, the postoperative residual lesions HPI will be higher,lower PVP, higher ALP, lower tITS （P 〈 0.05 ）. Conclusion：Dual-source CT whole liver perfusion imaging can evaluate the effect of transcatheter arterial chemoembo

关 键 词：原发性肝细胞肝癌 双源CT成像 全肝灌注 参与病灶 动脉导管化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]