基于CT和磁共振成像人工智能图像融合技术的适形消融用于肝癌TACE术后残留的疗效分析  

Analysis of the Therapeutic Effect of Conformal Ablation Based on Artificial Intelligence Assisted CT/MRI Image Fusion Technique for Residual Liver Cancer after TACE Procedure

作　　者：周永祥[1] 赵振国 张景俊[1] 王苑植 郭于风 首峰[1] ZHOU Yongxiang;ZHAO Zhenguo;ZHANG Jingjun;WANG Yuanzhi;GUO Yufeng;SHOU Feng(Department of Oncology,Jianyang People's Hospital,Jianyang,Sichuan 641500,China)

机构地区：[1]简阳市人民医院肿瘤科,四川简阳641500

出　　处：《临床误诊误治》2024年第21期67-72,78,共7页Clinical Misdiagnosis & Mistherapy

基　　金：四川省医学会关于批准(恒瑞)科研基金专项科研课题(2021HR02)。

摘　　要：目的分析基于CT和磁共振成像人工智能图像融合技术的适形消融用于肝癌肝动脉灌注化疗栓塞术(TACE)术后残留的效果及并发症发生情况。方法选取2019年1月至2023年11月收治的肝癌TACE术后残留患者61例,将CT和磁共振成像人工智能图像融合技术指导下适形消融30例(38个病灶)作为观察组,进行常规消融的31例(40个病灶)作为对照组。比较2组消融情况,消融前、消融后1个月肿瘤标志物[甲胎蛋白、癌胚抗原、糖类抗原125(CA125)],消融前、消融后24 h、消融后3 d肝功能指标[天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)];比较2组并发症发生率及无进展生存期。结果观察组术中即时补充消融率、术中满足消融边界率、完全消融率高于对照组,不完全消融率低于对照组(P<0.05,P<0.01);观察组消融后1个月甲胎蛋白、癌胚抗原、CA125低于对照组(P<0.05)。观察组消融后24 h、3 d AST、ALT低于对照组(P<0.05,P<0.01)。观察组并发症发生率[20.00%(6/30)]与对照组[32.26%(10/31)]比较差异无统计学意义(P>0.05);观察组再次消融率[3.33%(1/30)]与对照组[16.13%(5/31)]比较差异无统计学意义(P>0.05);观察组无进展生存期长于对照组(P<0.05)。结论CT和磁共振成像人工智能图像融合技术对TACE术后残留病灶消融治疗效果较好,且安全性较高。Objective To analyze the residual effect and the incidence of complications of conformal ablation based on artificial intelligence(AI)-assisted CT/magnetic resonance imaging(MRI)image fusion techniques for residual liver cancer after transcatheter arterial chemoembolization(TACE).Methods Sixty-one patients with residual liver cancer after TACE were selected from January 2019 to November 2023,and 30 patients(38 lesions)undergoing conformal ablation under the guidance of (AI)-assisted CT/MRI image fusion techniques were selected as the observation group,and 31 patients(40 lesions)underwent routine ablation were selected as the control group.The ablation conditions,the tumor markers[A-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)]before ablation and at 1 month after ablation,liver function indexes[aspartate aminotransferase(AST)and alanine aminotransferase(ALT)]before ablation,at 24 h after ablation and 3 d after ablation were compared between the two groups.The complication rate and progression-free survival(PFS)were compared between the two groups.Results The ablation rate of immediate supplementary ablation during operation,the ablation boundary during operation,and complete ablation in the observation group was higher than that of the control group,while the rate of incomplete ablation was lower than that of the control group(P<0.05,P<0.01).AFP,CEA and CA125 in the observation group were lower than those in the control group at 1 month after ablation(P<0.05).AST and ALT in the observation group were lower than those in the control group at 24 h and 3 d after ablation(P<0.05,P<0.01).There was no significant difference in the incidence of complications between the observation group[20.00%(6/30)]and the control group[32.26%(10/31)](P>0.05),nor in the reablation rate between the observation group[3.33%(1/30)]and the control group[16.13%(5/31)](P>0.05).The PFS was loner in the observation group than in the control group(P<0.05).Conclusion AI-assisted CT/MRI image fusion technique can

关 键 词：肝肿瘤 肝动脉灌注化疗栓塞术 术后残留 体层摄影术 螺旋计算机 磁共振成像 消融技术 癌胚抗原 丙氨酸转氨酶 

分 类 号：R735.7[医药卫生—肿瘤]