经肝动脉超声造影对经肝动脉栓塞化疗治疗肝细胞癌效果的评价  

Clinical value of transhepatic arterial contrast-enhanced ultrasonography in assessing efficacy of transarterial chemoembolization for hepatocellular carcinoma

作　　者：韩鹏 罗渝昆 费翔 姜波 王志军 贺崇 Han Peng;Luo Yukun;Fei Xiang;Jiang Bo;Wang Zhijun;He Chong(Department of Ultrasonography,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Interventional Radiology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心超声诊断科,北京100853 [2]中国人民解放军总医院第一医学中心介入放射科,北京100853

出　　处：《中华医学超声杂志（电子版）》2021年第1期45-49,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：人工智能辅助便捷式超声对腹部实质脏器战创伤自动诊断系统的建立(2H19021)。

摘　　要：目的探讨经肝动脉超声造影评价经肝动脉栓塞化疗(TACE)治疗肝细胞癌(HCC)效果的临床应用价值。方法选取解放军总医院第一医学中心2018年9月至2019年2月因肝肿瘤行TACE治疗的38例HCC患者(共48个病灶),分别行术前及术后即刻经肝动脉超声造影,通过观察肿瘤内及引流区是否增强评估疗效,并与TACE术后1个月的MRI结果进行对比。患者经肝动脉超声造影与MRI结果采用配对资料的χ^(2)检验,采用Kappa检验评价经肝动脉超声造影与MRI结果的一致性,并评价其诊断效能。结果术后即刻仅观察瘤内是否增强判断栓塞疗效与术后1个月MRI相比差异无统计学意义(P=0.289),同时观察肿瘤内及引流区是否增强判断疗效与术后1个月MRI相比差异无统计学意义(P=1.000),同时观察瘤内及引流区的评估结果一致性高于仅观察瘤内的评估结果(Kappa值:0.780 vs 0.664;P<0.001)。同时观察瘤内及引流区的评估结果特异度为84.2%、敏感度为93.1%、准确性为89.5%,均高于仅观察瘤内的评估结果(79.3%、89.4%、83.3%)。结论采用经肝动脉超声造影观察HCC瘤内及引流区是否增强可以术后即刻且准确地评价TACE治疗疗效,具有较高的临床价值。Objective To assess the clinical application value of transhepatic arterial contrastenhanced ultrasonography in evaluating the therapeutic effect of transarterial chemoembolization(TACE)for hepatocellular carcinoma(HCC).Methods Thirty-eight patients with 48 lesions of HCC underwent TACE at the First Medical Center of Chinese PLA General Hospital from September 2018 to February 2019.All of them underwent preoperative and postoperative transhepatic arterial contrast-enhanced ultrasonography to evaluate the therapeutic effect by observing the enhancement in tumor and drainage area.The outcomes of magnetic resonance imaging(MRI)one month after TACE were used for comparison.The results of transhepatic arterial contrast-enhanced ultrasonography and MRI were compared by theχ^(2) test,and the Kappa test was used to evaluate the consistency of the results of transhepatic arterial contrast-enhanced ultrasonography and MRI.Results The enhancement in tumor immediately after TACE was not different from the result of magnetic resonance imaging(MRI)one month after TACE(P=0.289).The enhancement in tumor and drainage area immediately after TACE was not different from the outcomes of magnetic resonance imaging(MRI)one month after TACE(P=1.000).The Kappa in observing the enhancement in tumor and drainage area was higher than that in observing the enhancement in tumor(0.780 vs 0.664,P<0.001).The specificity,sensitivity,and accuracy in observing the enhancement in both tumor and drainage area were 84.2%,93.1%,and 89.5%,respectively,which were higher than those in observing the enhancement in tumor alone(79.3%,89.4%,and 83.3%).Conclusion Transhepattic arterial contrast-enhanced ultrasonography could observe the enhancement in tumor and drainage area immediately after TACE,and has high clinical value in evaluating the therapeutic effect of TACE.

关 键 词：经肝动脉超声造影 引流区 经肝动脉栓塞化疗 肝细胞癌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]