双能CT影像学在肝癌肝动脉栓塞化疗术后效果判定中的应用价值分析  

Application Value Aanalysis of Dual-Energy CT Imaging in the Evaluation of Postoperative Effect of Hepatic Arterial Chemoembolization for Liver Cancer

作　　者：胡伟[1] 盛兆国 李正腾 张奉海 HU Wei;SHENG Zhaoguo;LI Zhengteng(Jining First People's Hospital,Shandong Jining 272000,China)

机构地区：[1]山东省济宁市第一人民医院核医学科,山东济宁272000 [2]山东省济宁市嘉祥惠民医院,山东济宁272400 [3]山东省莒县中医医院,山东莒县276500

出　　处：《河北医学》2022年第8期1336-1340,共5页Hebei Medicine

基　　金：山东省中医药科技发展计划项目,(编号:2019-0824)。

摘　　要：目的:双能CT影像学在原发性肝细胞癌(HCC)肝动脉栓塞化疗术后效果判定中的应用价值。方法:回顾性分析2019年1月至2020年1月收治的40例经肝动脉栓塞化疗术治疗的HCC患者影像学资料,术后4周以双能CT扫描检查方式获得常规CT图像和CT双能碘图。以DSA检查结果为金标准,比较两种CT检查方式对肝癌术后残留病灶的诊断效能;测量患者术后残留病灶与正常肝组织的CT双能碘图的碘浓度值(IC)、标准碘浓度值(NIC),判断其残留病灶活性。结果:以DSA检查结果为金标准,双能CT检测HCC术后残留病灶的敏感性、特异性及准确性均高于常规CT,比较差异有统计学意义(P<0.05)。ROC曲线显示:双能CT诊断HCC术后残留病灶的AUC为0.861,大于常规CT的0.658。HCC术后残留活性病灶的IC、NIC值高于正常肝组织,比较差异有统计学意义(P<0.05)。结论:双能CT影像学用于肝癌肝动脉栓塞化疗术后残留病灶检测的临床价值显著,其IC值与NIC值在判断病灶活性程度上有一定潜力。Objective:To analyze the application value of dual-energy CT imaging in the evaluation of postoperative effect of hepatic arterial chemoembolization for primary hepatocellular carcinoma(HCC).Methods:Imaging data of 40 patients with HCC treated by hepatic artery embolization chemotherapy admitted from January 2019 to January 2020 were retrospectively analyzed,with conventional CT images and CT dual-energy iodograms obtained by dual-energy CT scan examination 4 weeks after surgery.Using the results of DSA as the gold standard,the diagnostic efficacy of two CT examination methods for residual lesions after liver cancer surgery was compared.the iodine concentration values(IC)and standard iodine concentration values(NIC)of CT dual-energy iodograms of patients’postoperative residual lesions and normal liver tissue were measured to determine their residual lesion activity.Results:Using DSA findings as the gold standard,the sensitivity,specificity and accuracy of dual-energy CT in detecting residual lesions after HCC were higher than those of conventional CT,and the difference was statistically significant(P<0.05).The ROC curve showed that the AUC of dual-energy CT for the diagnosis of residual lesions after HCC was 0.861,which was greater than that of conventional CT at 0.658.The IC and NIC values of residual active lesions after HCC were higher than those of normal liver tissue,and the difference was statistically significant(P<0.05).Conclusion:Dual-energy CT imaging has significant clinical value in the detection of residual lesions after hepatic arterial chemoembolization for liver cancer,and its IC value and NIC values have a certain potential in judging the degree of lesion activity.

关 键 词：肝癌 双能CT影像学 常规CT 肝动脉栓塞化疗术 残留病灶活性 

分 类 号：R735.7[医药卫生—肿瘤]