CEUS和增强螺旋CT对原发性肝细胞癌TACE治疗效果的评估价值  

Evaluation value of contrast-enhanced ultrasound and contrast-enhanced spiral CT in the TACE treatment of primary hepatocellular carcinoma

作　　者：韩宗宝 李希 梁子懿 王仁贵[1] HAN Zongbao;LI Xi;LIANG Ziyi;WANG Rengui(Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038 China)

机构地区：[1]首都医科大学附属北京世纪坛医院,北京100038

出　　处：《中国辐射卫生》2024年第5期600-606,共7页Chinese Journal of Radiological Health

摘　　要：目的分析对比增强超声(CEUS)和增强螺旋CT应用于原发性肝细胞癌(PHC)经导管肝动脉化疗栓塞术(TACE)患者,对其治疗效果的评估价值。方法回顾性分析2021年7月—2023年6月于首都医科大学附属北京世纪坛医院治疗的PHC患者108例(122个病灶),均给予TACE治疗,治疗后进行CEUS、增强螺旋CT检查,用以评估肿瘤病灶的灭活情况,以病理结果为金标准,采用受试者操作特征(ROC)曲线及决策树模型综合评估CEUS、增强螺旋CT、二者联合对PHC的诊断价值。结果病理结果显示,79个病灶残留(阳性),43个病灶彻灭活(阴性)。ROC曲线分析显示,CEUS、增强螺旋CT、二者联合评估PHC疗效的AUC分别为0.975、0.918、0.994,CEUS、二者联合的敏感度、阳性预测值、实际应用准确性高于增强螺旋CT(P<0.05)。以PHC疗效为因变量,以CEUS、增强螺旋CT、二者联合为自变量分别构建PHC疗效决策树诊断模型,误判率分别为3.3%、10.7%、0.8%,预测准确率分别为96.7%、89.3%、99.2%。结论CEUS、CEUS联合增强螺旋CT对PHC治疗疗效均具有较高的评估价值。Objective Analyze and compare the therapeutic value of contrast-enhanced ultrasound(CEUS)and enhanced spiral CT in patients with primary hepatocellular carcinoma(PHC)undergoing transcatheter arterial chemoembolization(TACE).Methods A retrospective analysis was conducted on 108 PHC patients(122 lesions)treated at Beijing Shijitan Hospital affiliated with Capital Medical University from July 2021 to June 2023.All patients were treated with TACE.After treatment,CEUS and contrast-enhanced spiral CT examinations were performed to evaluate the inactivation status of tumor lesions,with pathological results as the gold standard.The receiver operating characteristic curve and decision tree model were used to comprehensively evaluate the diagnostic value of CEUS,contrast-enhanced spiral CT,and their combination in PHC.Results The pathological results showed that 79 lesions remained active(positive)and 43 lesions were completely inactivated(negative).The areas under the receiver operating characteristic curve for evaluating PHC treatment efficacy by CEUS,contrast-enhanced spiral CT,and their combination were 0.975,0.918,and 0.994,respectively.The sensitivity,posit-ive predictive value,and actual application accuracy of CEUS and the combined method were higher than those of contrast-enhanced spiral CT(P<0.05).A decision tree diagnostic model for PHC treatment efficacy was constructed using CEUS,contrast-enhanced spiral CT,and their combination as independent variables and PHC treatment efficacy as the dependent variable.The misjudgment rates were 3.3%,10.7%,and 0.8%,respectively,and the prediction accuracy was 96.7%,89.3%,and 99.2%,respectively.Conclusions CEUS and the combination of CEUS and contrast-enhanced spiral CT have high evaluation value for PHC treatment efficiency.

关 键 词：原发性肝细胞癌 对比增强超声 增强螺旋CT 疗效 评估 

分 类 号：R445[医药卫生—影像医学与核医学]