能谱CT多参数定量分析评价原发性肝癌TACE术后疗效的应用研究  

Clinical application of multi-parameter quantitative analysis based on energy spectrum CT to evaluate the efficacy of TACE after primary liver cancer

作　　者：张晓东 陈本宝 胡舟朝 陈蓉蓉 ZHANG Xiaodong;CHEN Benbao;HU Zhouchao(Zhoushan Hospital,Zhejiang 316000,China)

机构地区：[1]舟山医院,舟山316000 [2]舟山市中医院

出　　处：《浙江创伤外科》2024年第11期2010-2013,共4页Zhejiang Journal of Traumatic Surgery

基　　金：舟山市科学技术局2022年度市级公益类计划项目(2022C31013)。

摘　　要：目的探讨基于能谱电子计算机断层扫描(CT)多参数定量分析评价原发性肝癌肝动脉化疗栓塞(TACE)术后疗效的临床应用价值。方法选择2021年1月至2022年12月本院收治的62例原发性肝癌TACE术后复查患者为研究对象。均在术后1个月接受影像学检查,将数字减影血管造影技术(DSA)及影像后续随访结果作为金标准,比较能谱CT所得能谱图像(Mono)和常规混合能量图像(QC)的差异。结果有效组的IC病灶、NIC、λ、LNR低于无效组,动脉期NIC、门脉期NIC高于无效组(P<0.05)。70 keV、80 keV、90 keV Mono图像和QC图像的ROI 1高于ROI 2(P<0.05);110 keV Mono的SNR高于QC(P<0.05)。能谱CT多参数定量分析诊断原发性肝癌患者TACE术后疗效的曲线下面积AUC(0.891),与DSA诊断结果一致性较高(Kappa=0.78,P<0.05)。结论在原发性肝癌TACE术后疗效评估中采取能谱CT多参数定量分析,能达到一定的检出效果,不同预后情况者的检出结果差异显著,能谱CT的特异度、敏感度较高。Objective To investigate the clinical application of multi-parameter quantitative analysis based on energy spectrum electronic computed tomography(CT)to evaluate the postoperative efficacy of hepatic artery chemoembolization(TACE)for primary liver cancer.Methods 62 patients with primary liver cancer who received TACE reexamination in our hospital from January 2021 to December 2022 were selected as the study objects.Digital subtraction angiography(DSA)and follow-up results were used as the gold standard to compare the difference between energy spectrum images(Mono)and conventional mixed energy images(QC)obtained by energy spectrum CT,so as to explore the application value of energy spectrum CT multi-parameter quantitative analysis of the postoperative efficacy of TACE for primary liver cancer.Results The IC foci,NIC,λand LNR of the effective group were lower than those of the ineffective group,while the arterial phase NIC and portal phase NIC were higher than those of the ineffective group.The ROI 1 of 70 keV,80 keV,90 keV Mono images and QC images was higher than that of ROI 2(P<0.05).The SNR of 110 keV Mono was higher than that of QC(P<0.05).The area under the curve AUC(0.891)of TACE in patients with primary liver cancer diagnosed by multi-parameter quantitative analysis of energy spectrum CT was in high consistency with DSA diagnosis(Kappa=0.78,P<0.05).Conclusion The multi-parameter quantitative analysis of energy spectrum CT can achieve a certain detection effect in the evaluation of the curative effect of primary liver cancer after TACE surgery.The detection results of different prognoses are significantly different,and the specificity and sensitivity of energy spectrum CT are high.

关 键 词：原发性肝癌 能谱CT 多参数定量 肝动脉化疗栓塞 临床疗效 效能分析 

分 类 号：R735.7[医药卫生—肿瘤]