能谱CT与超声造影评价肝癌DEB-TACE疗效的对比研究  

Comparative Study of Energy Spectrum CT and Ultrasonography to Evaluate the Efficiency of DEB-TACE in Hepatocellular Carcinoma

作　　者：袁慧锋[1] 叶书文 李臻[1] YUAN Hui-feng;YE Shu-wen;LI Zhen(Department of Radiological Interventions,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院放射介入科,河南郑州450052

出　　处：《中国CT和MRI杂志》2024年第9期94-96,共3页Chinese Journal of CT and MRI

基　　金：中国健康促进基金会肿瘤介入科研基金(XM2018011000601)。

摘　　要：目的对比分析能谱CT与超声造影在评价肝癌DEB-TACE术后疗效评估的应用价值。方法前瞻性纳入在郑州大学第一附属医院放射介入科接受DEB-TACE治疗的38例肝细胞癌患者,所有患者均于DEB-TACE术后4~6周接受CT能谱扫描和声学造影用评价以疗效,检查后一周内接受DSA检查。将DSA检查结果作为“金标准”,分析能谱CT与超声造影评估肝细胞癌DEB-TACE疗效的差异。应用SPSS23.0统计分析相关数据,计算两种方法的灵敏度、特异度、漏诊率、误诊率、约登指数,MedCalc绘制ROC曲线,通过对比AUC来比较两种检查方法的检验效能。结果能谱CT诊断残癌或复发的结果:灵敏度为93.33%,特异度为100.0%,误诊率为0.0%,漏诊率为6.67%,正确率94.74%,约登指数93.33%。超声造影诊断残癌或复发的结果:灵敏度76.67%,特异度100.00%,误诊率0%,漏诊率23.33%,正确率81.58%,约登指数76.67%。能谱CT和声学造影的曲线下面积分别为0.967、0.883,统计学差异显著(P<0.05)。结论对比声学造影,能谱CT对评估肝细胞癌DEB-TACE疗效评价的准确性更高,在肝细胞DEB-TACE术后患者疗效评估中有重要价值。Objective Comparative analysis of energy spectrum CT and ultrasonography in evaluating the efficacy assessment after DEB-TACE for hepatocellular carcinoma.Methods 38 patients with hepatocellular carcinoma who underwent DEB-TACE at the Department of Radiological Intervention of the First Affiliated Hospital of Zhengzhou University were prospectively enrolled,and all of them underwent CT energy spectral scanning and acoustic imaging for efficacy assessment 4 to 6 weeks after DEB-TACE,and DSA within 7 days after the end of the examination.DSA results were used as the gold standard to analyze the difference in the efficacy of DEB-TACE for hepatocellular carcinoma assessed by energy spectrum CT and ultrasonography.SPSS21.0 software was used for statistical analysis to calculate the sensitivity,specificity,leakage rate,misdiagnosis rate,and Jordon's index of the two methods,and MedCalc plotted the ROC curves to compare the test efficacy of the two examination methods by comparing the AUC.Results The results of spectral CT for diagnosing residual cancer or recurrence:sensitivity 93.33%,specificity 100.0%,misdiagnosis rate 0.0%,leakage rate 6.67%,correct rate 94.74%,and Yoden index 93.33%.The results of ultrasonography in diagnosing residual cancer or recurrence:sensitivity 76.67%,specificity 100.00%,misdiagnosis rate 0%,leakage rate 23.33%,correct rate 81.58%,and Yoden index 76.67%.The area under the curve of energy spectrum CT and acoustic imaging were 0.967 and 0.883,respectively,and there was a significant difference between the two comparisons(P<0.05).Conclusion Compared with acoustic imaging,energy-spectrum CT is more accurate in evaluating the efficacy of DEB-TACE in hepatocellular carcinoma,and is valuable in the evaluation of patient outcomes after hepatocellular DEB-TACE.

关 键 词：肝癌 能谱CT 超声造影 灵敏度 特异度 经导管肝动脉化疗栓塞术 

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