MSCTPI与CEUS在肝癌介入疗效及术后肿瘤活性评估中的应用价值  

Application value of MSCTPI and CEUS in evaluation of interventional efficacy and postoperative tumor activity in liver cancer

作　　者：高越[1] 曾庆[1] 池盟盟 邓俊魁 GAO Yue;ZENG Qing;CHI Meng-meng;DENG Jun-kui(Nanyang Central Hospital Interventional Catheterization Room,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院介入导管室,河南南阳473000

出　　处：《医药论坛杂志》2023年第23期52-55,共4页Journal of Medical Forum

摘　　要：目的探讨多层螺旋电子计算机断层扫描灌注成像(multi-slice spiral computed tomography perfusion ima-ging,MSCTPI)与超声造影(contrast-enhanced ultrasound,CEUS)对肝细胞癌介入治疗患者术后肿瘤细胞活性的评估价值。方法选取2021年1月至2022年3月在南阳市中心医院接受动脉导管化疗栓塞术治疗的248例肝细胞癌患者为研究对象,所有患者均在介入栓塞手术后7 d进行MSCTPI和CEUS检查,对病灶血运进行评估,并以数字减影血管造影(digital subtraction angiography,DSA)作为金标准分别对MSCTPI和CEUS检查结果进行诊断效能评价。结果MSCTPI和CEUS的诊断灵敏性比较,差异无统计学意义(P>0.05);MSCTPI特异度和准确率分别为94.93%、95.16%,明显高于CEUS的82.89%、84.27%,差异具有统计学意义(P<0.05)。经CEUS诊断显示,残留病灶类型主要以环形、团状或结节型为主,动脉期病灶残留增强,而门脉期和延迟期增强明显减弱。经MSCTPI显示,病灶内栓塞碘油沉积呈不均匀状,甚至部分区域有稀疏现象,与正常肝组织相比,残留病灶HAP较高,PVP、MTT水平较低,差异有统计学意义(P<0.05)。结论MSCTPI在肝癌介入术后疗效评估中效果更为显著,可以对存留病灶的情况进行准确评估,值得临床广泛的推广与应用。Objective To explore the evaluation value of multi-slice spiral computed tomography perfusion imaging(MSCTPI)and contrast-enhanced ultrasound(CEUS)in postoperative tumor cell activity in patients with hepatocellular carcinoma undergoing interventional therapy.Methods Totally 248 patients with hepatocellular carcinoma who underwent interventional embolization therapy in Nanyang Central Hospital from January 2021 to March 2022 were selected as the study subjects.All patients underwent MSCTPI and CEUS examinations 7 days after interventional embolization surgery to evaluate the blood flow of the lesion.The diagnostic efficacy of MSCTPI and CEUS examinations was evaluated using digit-al subtraction angiography(DSA)as the gold standard.Results There was no statistically significant difference in diag-nostic sensitivity between MSCTPI and CEUS(P>0.05);The specificity and accuracy of MSCTPI were 94.93%and 95.16%,respectively,which were significantly higher than those of CEUS(82.89%and 84.27%),and the difference was statistically significant(P<0.05).According to CEUS diagnosis,the main types of residual lesions were circular,clustered,or nodular.The residual lesions in the arterial phase was enhanced,while the enhancement in the portal and delayed phases was significantly weakened.MSCTPI showed that the deposition of iodinated oil in the embolic lesions was uneven,and even sparse was some areas.Compared with normal liver tissue,the residual lesions had higher HAP,lower levels of PVP and MTT,and the difference was statistically significant(P<0.05).Conclusion MSCTPIhas a more sig-nificant effect in evaluating the efficacy of liver cancer intervention surgery,and can accurately evaluate the situation of re-sidual lesions,which is worthy of widespread clinical promotion and application.

关 键 词：动脉导管化疗栓塞 多层螺旋电子计算机断层扫描灌注成像 超声造影 肝癌 肿瘤活性 

分 类 号：R735.7[医药卫生—肿瘤]