低剂量全肝灌注CT评价肝细胞癌TACE术后残余肿瘤活性  

Low-dose whole-liver CT perfusion of residual viable hepatocellular carcinoma after transcatheter arterial chemoembolization

作　　者：王超 马士亮 曹邱婷 韩昕君 段永利[5] 梁小红 闫城 邢颖[2] 张洪义 赵丽琴 WANG Chao;MA Shi-liang;CAO Qiu-ting;HAN Xin-jun;DUAN Yong-li;LIANG Xiao-hong;YAN Cheng;XING Ying;ZHANG Hong-yi;ZHAO Li-qin(Department of Radiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院放射科,北京100070 [2]首都医科大学附属北京天坛医院普外科,北京100070 [3]北京丰台右安门医院放射科,北京100069 [4]首都医科大学附属北京友谊医院放射科,北京100050 [5]首都医科大学附属北京世纪坛医院放射科,北京100038

出　　处：《影像诊断与介入放射学》2022年第6期446-451,共6页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金(面上项目)(82072003)。

摘　　要：目的探讨低剂量全肝灌注CT在肝细胞癌(HCC)经动脉化疗栓塞(TACE)术后残余肿瘤活性组织血流动力学变化判断中的价值。方法选取行TACE治疗的HCC患者,所有患者均在治疗后4~6周行低剂量全肝灌注CT扫描。选取其中有残余肿瘤活性组织的病例共30例,使用肝脏肿瘤灌注软件对坏死组织(T1)、残余活性肿瘤组织(T2)及背景肝组织(T3)进行灌注参数测量,包括肝动脉灌注分数(HAF,%)、毛细血管表面通透性(PS,ml/min/100 g)、血容量(BV,ml/100 g)、达峰时间(TTP,s)。采用单因素配对符号秩和检验对T2与T1、T3之间的差异进行对比。结果共发现35个有残余肿瘤活性组织的HCC病变,T2的HAF、PS、BV均高于T1与T3(P<0.05);T2与T1、T3之间的TTP差异均无统计学意义(P>0.05)。有效辐射剂量约(19.71±4.28)mSv。结论低剂量全肝灌注CT可反映HCC TACE术后残余活性肿瘤组织的血流动力学改变,从而对HCC进一步治疗策略的选择提供可靠依据。Objective To investigate the value of low-dose whole-liver CT perfusion(CTP)in assessing the hemodynamics of residual viable hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE).Methods Thirty patients with HCC underwent low-dose whole-liver perfusion CT 4-6 weeks after TACE.The hepatic arterial fraction(HAF,%),capillary surface permeability(PS,ml/min/100 g),blood volume(BV,ml/100 g),and time to peak(TTP,s)of necrotic tissue(T1),residual viable tumor tissue(T2)and background liver tissue(T3)were obtained using liver tumor perfusion software.Univariate Wilcoxon signed rank test was used to compare the perfusion parameters of T2 with T1 and T3.Results 35 HCC lesions with residual viable tumor tissue were found with significantly higher HAF,PS and BV than those of T1 and T3(P<0.05).There was no significant difference in TTP(P>0.05).The effective radiation dosage was(19.71±4.28)mSv.Conclusion Low-dose whole-liver perfusion CT demonstrates the hemodynamics of residual viable HCC after TACE,which is valuable for selecting further treatment protocol.

关 键 词：肝细胞癌 经动脉化疗栓塞 残余活性肿瘤组织 低剂量 体层摄影技术 X线计算机 灌注成像 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学] R814.42