ICG联合CT灌注成像在肝癌术前评估肝储备功能的临床应用研究  

Clinical Application of ICG Combined with CT Perfusion Imaging in Preoperative Evaluation of Liver Reserve Function in Liver Cancer Surgery

作　　者：张龙 陈杨金 何勇[1] 叶荣强[1] 邓星星 Zhang Long(Hepatobiliary and Pancreatic Surgery Department of Ganzhou People’s Hospital,Ganzhou Jiangxi 341000)

机构地区：[1]赣州市人民医院肝胆胰腺外科,江西赣州341000 [2]于都县中医院普外科,江西于都342300 [3]赣州市人民医院影像科,江西赣州341000

出　　处：《黑龙江医药》2023年第4期822-825,共4页Heilongjiang Medicine journal

基　　金：江西省卫生健康委科技计划项目(编号:202212479)。

摘　　要：目的:分析吲哚菁绿(ICG)排泄试验联合CT灌注成像在肝癌术前肝储备功能中的评估作用。方法:选取2021年4月—2023年4月本院收治的90例行手术的肝癌患者,所有患者按照肝功能Child-Pugh分级分为A组(n=30)、B组(n=30)、C组(n=30),统计对比两组ICG排泄试验及CT灌注成像有关参数的差异;另绘制受试者工作曲线(ROC),分析ICG排泄试验、CT灌注成像有关参数单独或联合在肝癌患者术前肝储备功能评估中的作用。结果:C组的吲哚菁绿15分钟滞留率(ICGR15)、肝动脉灌注量(HAP)、肝动脉灌注指数(HAPI)高于B组、A组,门静脉灌注量(PVP)、总肝灌注量(TLP)低于B组、A组,且B组的ICGR15、HAP、HAPI高于A组,PVP、TLP低于A组,差异有统计学意义(P<0.05);ROC结果显示,ICGR15、HAP、PVP、TLP、HAPI联合评估肝癌患者术前肝储备功能的曲线下面积(AUC)高于几者单独评估。结论:ICG排泄试验联合CT灌注成像能够在一定程度上于术前评估肝癌患者的肝储备功能,具有一定的应用价值。Objective:To analyze the role of indocyanine green(ICG)excretion test combined with CT perfusion imaging in evaluating liver reserve function before liver cancer surgery.Method:90 Cases liver cancer patients who underwent surgery in our hospital from April 2021 to April 2023 were selected.All patients were divided into Group A(n=30),Group B(n=30),and Group C(n=30)according to the Child Pugh classification of liver function.The differences in ICG excretion test and CT perfusion imaging parameters between the two groups were statistically compared;Additionally,draw a receiver operating curve(ROC)to analyze the role of ICG excretion test and CT perfusion imaging parameters,individually or in combination,in preoperative liver reserve function assessment in liver cancer patients.Result:The 15 minute retention rate(ICGR15),hepatic artery perfusion volume(HAP),and hepatic artery perfusion index(HAPI)of indocyanine green in Group C were higher than those in Group B and Group A.The portal vein perfusion volume(PVP)and total hepatic perfusion volume(TLP)were lower than those in Group B and Group A.Moreover,the ICGR15,HAP,and HAPI of Group B were higher than those in Group A,while the PVP and TLP were lower than those in Group A,with statistical significance(P<0.05);The ROC results showed that the area under the curve(AUC)of ICGR15,HAP,PVP,TLP,and HAPI combined evaluation for preoperative liver reserve function in liver cancer patients was higher than those evaluated separately.Conclusion:The combination of ICG excretion test and CT perfusion imaging can to some extent evaluate the liver reserve function of liver cancer patients before surgery,and has certain application value.

关 键 词：肝癌 肝储备功能 吲哚菁绿排泄试验 CT灌注成像 

分 类 号：R735.7[医药卫生—肿瘤]