DECT判定TACE术后原发性肝细胞癌残留状态的价值  

The value of DECT in determining the residual status of hepatocellular carcinoma after TACE

作　　者：龚如林 梅贵丽 陈杰[2] GONG Rulin;MEI Guili;CHEN Jie(Department of Intervention,Haian Hospital Affiliated to Nantong University,Jiangsu Nantong 226600,China;Department of Radiology,Zhejiang Tumor Hospital,Zhejiang Hangzhou 310022,China)

机构地区：[1]南通大学附属海安医院介入科,江苏南通226600 [2]浙江省肿瘤医院放射科,浙江杭州310022

出　　处：《现代肿瘤医学》2020年第22期3956-3959,共4页Journal of Modern Oncology

摘　　要：目的:运用双能量CT(dual-energy CT,DECT)判定原发性肝细胞癌经导管肝动脉化疗栓塞术(transcatheter artery chemoembolization,TACE)后肿瘤残留状态,并探讨其临床价值。方法:回顾性分析在本院行TACE术治疗的65例原发性肝细胞癌患者,共82个病灶。行上腹部CT常规平扫及增强扫描(动脉期作双能扫描)。根据动脉期图像处理方法不同分为:A法,采用常规融合法处理图像;B法,采用改良融合法处理图像。以DSA作为判定“金标准”,判定两种方法对TACE术后肿瘤残留的诊断效能。结果:B法判定TACE术后肿瘤残留的敏感度(94.83%)、特异度(95.83%)、准确性(95.12%)明显高于A法(81.03%、75.00%、79.27%),差异均有统计学意义(P<0.05);B法与DSA诊断结果的一致性较好(Kappa=0.885,P=0.000),明显优于A法(Kappa=0.528,P=0.000)。结论:DECT动脉期改良融合图像能敏感发现原发性肝细胞癌TACE术后肿瘤残留,且优于常规融合图像,能有效监测TACE术后疗效,具有较高临床应用价值。Objective:To determine the residual state of hepatocellular carcinoma(HCC)after(transcatheter artery chemoembolization)TACE by dual-energy CT(DECT),and to explore its clinical value.Methods:65 patients with HCC treated with TACE in our hospital were retrospectively analyzed,with a total of 82 lesions.Conventional CT scan and enhanced scan(dual-energy scan in the arterial phase)of the upper abdomen were performed.According to the different processing methods of arterial phase image,there was A method,using conventional fusion method to process images and B method,using improved fusion method to process images.DSA was used as the"golden standard"to determine the diagnostic efficacy of the two methods for tumor residue after TACE.Results:The sensitivity(94.83%),specificity(95.83%)and accuracy(95.12%)of B method were significantly higher than those of A method(81.03%,75.00%,79.27%)(P<0.05).The consistency between B method and DSA(Kappa=0.885,P=0.000)was significantly better than that of A method(Kappa=0.528,P=0.000).Conclusion:The arterial improved fusion image of DECT can sensitively detect the residual HCC after TACE,which is better than conventional fusion image,can effectively monitor the efficacy of TACE,and has high clinical application value.

关 键 词：体层摄影术 双能量CT 原发性肝细胞癌 TACE术 疗效 

分 类 号：R735.7[医药卫生—肿瘤]