超声造影定量评估TACE术后原发性肝细胞癌的血流灌注变化  

Quantitative evaluation of blood perfusion in hepatocellular carcinoma after transcatheter arterial chemoembolization by contrast-enhanced ultrasound

作　　者：张心荣 欧阳骏 黄敬垣 Xin-Rong Zhang;Jun Ouyang;Jing-Yuan Huang(Department of Ultrasonography,Deqing People’s Hospital,Huzhou 313200,Zhejiang Province,China;Department of Ultrasonography,Shulan (Hangzhou) Hospital,Hangzhou 310022,Zhejiang Province,China)

机构地区：[1]浙江省德清县人民医院B超室,浙江省湖州市313200 [2]树兰(杭州)医院超声科,浙江省杭州市310022

出　　处：《世界华人消化杂志》2019年第4期276-281,共6页World Chinese Journal of Digestology

摘　　要：目的探讨超声造影(contrast-enhanced ultrasound, CEUS)定量评估经导管肝动脉化疗栓塞术(transcatheter arterychemo-embolization, TACE)后原发性肝细胞癌(Hepatocellular Carcinoma, HCC)残留肿瘤的血流灌注状态及其应用价值.方法选取浙江省德清县人民医院收治并接受TACE治疗的45例HCC患者作为研究对象,共57个肿瘤,分别于治疗前1 d、治疗后1 mo行CEUS,比较TACE前后残留肿瘤的血流灌注参数.结果 CEUS判定HCC肿瘤残留的灵敏度=95.45%,准确度=94.74%,特异度=92.31%;术后HCC残留肿瘤的增强强度(56.87%±4.15%)较治疗前(75.09%±6.42%)明显下降,差异有统计学意义(P<0.05);术后HCC残留肿瘤的达峰时间(25.26 s±3.83 s)较治疗前(21.02s±3.70s)明显延长,差异有统计学意义(P <0.05);术后HCC残留肿瘤的曲线下面积(581.29±86.43)较治疗前(1017.83±111.76)明显减少,差异有统计学意义(P <0.05).结论 CEUS能直观反映HCC经TACE治疗后肿瘤残留状态,并能定量评估残留肿瘤的血流灌注变化,可为临床进一步治疗提供血流动力学信息.AIM To evaluate the blood perfusion status of residual hepatocellular carcinoma(HCC)tumors after transcatheter arterial chemoembolization(TACE)by contrast-enhanced ultrasound(CEUS)as well as the application value of CEUS.METHODS A total of 45 HCC patients with a total of 57 tumors who underwent TACE at our hospital were selected.CEUS was performed one day before treatment and one month after treatment.The blood perfusion parameters of residual tumors before and after TACE were compared.RESULTS The sensitivity,accuracy,and specificity of CEUS in the diagnosis of residual HCC lesions were 95.45%,94.74%,and 92.31%,respectively.The enhanced intensity(56.87%±4.15%)of residual HCC tumors after TACE decreased significantly compared with that(75.09%±6.42%)before TACE(P<0.05).The peak time(25.26 s±3.83 s)of HCC residual tumors after TACE was significantly longer than that(21.02 s±3.70 s)before TACE(P<0.05).The area under the curve(581.29±86.43)for residual HCC tumors decreased significantly compared with that(1017.83±111.76)before TACE(P<0.05).CONCLUSION CEUS can directly reflect the residual state of HCC after TACE and quantitatively evaluate the blood perfusion change of residual tumors,which can provide hemodynamic information for further clinical treatment.

关 键 词：超声造影 原发性肝细胞癌 经导管肝动脉化疗栓塞术 血流灌注 

分 类 号：R735.7[医药卫生—肿瘤]