螺旋CT灌注成像与超声造影在肝癌介入疗效及术后肿瘤活性评估中的应用  

Application of Spiral CT Perfusion Imaging and Contrast-enhanced Ultrasound in the Evaluation of Interventional Efficacy of Hepatocellular Carcinoma and Postoperative Tumor Activity

作　　者：曹青峰[1] CAO Qing-feng(Department of Ultrasonography,Zhengzhou People’s Hospital,Zhengzhou 450003,Henan Province,China)

机构地区：[1]郑州人民医院超声科,河南郑州450003

出　　处：《中国CT和MRI杂志》2021年第2期94-95,117,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨多层螺旋电子计算机断层扫描灌注成像(MSCTPI)与超声造影(CEUS)在肝癌介入疗效及术后肿瘤活性评估中的应用价值。方法选择2017年1月至2018年12月间行经肝动脉灌注导管化疗栓塞术(TACE)治疗的124例肝癌患者作为研究对象。所有患者均进行MSCTPI和CEUS检查,评估TACE治疗效果。以数字减影血管造影(DSA)作为“金标准”,比较病灶术后肿瘤活性诊断效能。结果MSCTPI诊断肝癌经TACE术后疗效,灵敏度、特异度、准确率、阳性预测值、阴性预测值均高于CEUS;CEUS显示:残留病灶表现为显著增强或等增强,以结节性、团块和病灶环形增强为主,动脉期病灶残留区增强,门脉期和延迟期增强减退;MSCTPI显示:残留病灶呈现肝动脉高血流灌注表现,门静脉低灌注值,残留病灶HAP高于正常肝组织(P<0.05),PVP、MTT低于正常肝组织(P<0.05)。结论MSCTPI在肝癌TACE术后疗效评估中优于CEUS,评估残留病灶效能更高。Objective To explore the application value of multi-slice spiral computed tomography perfusion imaging(MSCTPI)and contrast-enhanced ultrasound(CEUS)in the evaluation of interventional efficacy of hepatocellular carcinoma and postoperative tumor activity.Methods A total of 124 patients with hepatocellular carcinoma who underwent transcatheter arterial chemoembolization(TACE)from January 2017 to December 2018 were included as study subjects.All patients underwent MSTPI and CEUS examinations to evaluate the effect of TACE treatment.Digital subtraction angiography(DSA)was used as the gold standard to compare the diagnostic efficacy of postoperative tumor activity.Results The sensitivity,specificity,accuracy rate,positive predictive value,and negative predictive value of MSCTPI in diagnosing effictiveness after TACE for hepatocellular carcinoma were all higher than those of CEUS.CEUS displayed that the residual lesions showed significant enhancement or equal enhancement,mainly with nodal,mass,and ring-shaped enhancement of lesions,and showed enhancement in the residual area of lesion artery phase and declined enhancement in portal phase and delayed phase.MSCTPI displayed that the residual lesions showed hepatic artery high blood perfusion and low portal vein perfusion value,and the HAP of the residual lesion was higher than that of normal liver tissue(P<0.05)while the PVP and MTT were lower than those of normal liver tissues(P<0.05).Conclusion MSCTPI is superior to CEUS in evaluating efficacy after TACE for hepatocellular carcinoma,and it is more effective in evaluating residual lesions.

关 键 词：肝癌 经肝动脉灌注导管化疗栓塞术 螺旋CT灌注成像 超声造影 

分 类 号：R445[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]