摘要
目的探讨全肝灌注CT增强扫描检查在肝癌TACE术后局部病灶活性评估中的作用。方法 38例行TACE治疗的肝癌患者,术后6周在Siemens128排CT上行全肝灌注CT增强扫描和DSA造影。根据全肝灌注扫描图像获得肝脏灌注参数,与DSA造影结果进行对比,以DSA造影作为标准,分别分析CT灌注对TACE术后局部肿瘤活性的显示情况。结果全肝CT灌注共检出病灶42处(100%),诊断正确率88.09%,灵敏度94.11%,特异度62.50%,阳性预测值=91.42%;阴性预测值=71.42%;一致性检验Kappa值0.8613。TACE术后局部肿瘤生长区的相关灌注参数与非瘤区肝组织的灌注参数,两者的血流量(BF)、血容量(BV)、肝动脉指数(HAI)和肝门脉灌注(PVP)差异均有统计学意义(P<0.01)。结论全肝灌注CT增强扫描能很好的显示肝癌TACE术后局部病灶的活性,在肝癌TACE术后评估中具有较高的应用价值。
Objective To discuss the clinical application of whole-liver perfusion-enhanced CT imaging in evaluating the activity of residual hepatocellular carcinoma（HCC） after transcatheter arterial chemoembolization（TACE）.Methods Whole-liver perfusion-enhanced CT scanning by using a Siemens 128-slice CT scanner was performed in thirty-eight patients with HCC six weeks after they received TACE.Arterial angiography with a DSA was also carried out.These two examinations were completed sequentially within one week.Hepatic perfusion parameters were obtained from whole-liver perfusion-enhanced CT images,which were compared with angiographic results.Taking the angiographic manifestations as the standards,the value of whole-liver perfusion-enhanced CT scanning in detecting the activity of residual HCC after TACE was assessed.Results A total of 42 lesions were detected on whole-liver CT perfusion images in 38 patients,with a diagnostic accuracy of 88.09%,sensitivity of 94.11% and specificity of 62.50% for the detection of residual tumor that carried blood supplies.The positive and negative predictive values were 91.42% and 71.42%,respectively.The Kappa value was 0.8613.After TACE,The difference in relevant perfusion parameters,including BF,BV,HAI and PVP,between residual active HCC and the non-HCC area was significant（P〈0.01）.Conclusion Whole-liver perfusion-enhanced CT scanning can well display the activity of residual HCC after TACE.Therefore,as an effective and noninvasive examination this technique is very useful in evaluating the results of TACE for HCC.
出处
《介入放射学杂志》
CSCD
北大核心
2010年第7期540-543,共4页
Journal of Interventional Radiology
基金
上海市重点学科建设项目资助(编号:S30203)
上海交通大学医学院重点学科
关键词
肝细胞癌
CT灌注成像技术
栓塞
hepatocellular carcinoma
CT perfusion imaging
embolization
