摘要
目的评价双源CT（DSCT）双能量成像对肝癌经皮肝动脉化疗栓塞（TACE）术后病灶复查的应用价值。方法对27例接受TACE治疗的原发性肝癌患者资料进行回顾性分析，27例均行常规肝脏平扫及动态三期增强扫描，其中动脉期图像由双能量扫描方式获得。采用2种方法观察，A法观察常规平扫、动脉期、门静脉期及延迟期图像，B法观察虚拟平扫、动脉期、门静脉期及延迟期图像，评价2种方法对栓塞病灶内部及其周围肝组织内强化信息的判断。以DSA结果为参照标准，计算A、B2法的敏感性、特异性等指标，采用X^2检验比较两种方法的诊断能力。结果27例TACE术后复查患者中共检出63个病变，DSA明确其％（29／39；X^2=6．303，P〈0．05）；B法的特异性为95．8％（23／24），与A法的83．3％（20／24）差异无中39个病变有强化，24个病变无强化。B法的敏感性为94．9％（37／39），高于A法的74．4统计学意义（X^2=2．009，P〉0．05）。结论以动脉期双能量扫描代替常规CT平扫与动脉期增强扫描，与常规CT动态增强相比，对TACE术后肝癌病灶的评估更加准确。
Objective To assess the diagnostic value of dual-energy dual-source CT in detecting the enhancement of hepatocellular cancer （ HCC ） after transarterial chemoembolization （ TACE ） treatment. Methods Twenty-seven patients with HCC underwent dual-energy dual-source CT including nonenhanced, arterial, portal, and delayed phases scanning after TACE treatment. Arterial phases were acquired with the dual-energy mode for reconstruction of virtual nonenhanced images and color overlay images. DSAs were performed in all these patients. Two blinded and independent readers evaluated the data in 2 reading sessions： standard nonenhanced, arterial phase, portal phase, and delayed phase images were read in session A, and virtual nonenhanced, arterial phase, portal phase, and delayed phase images in session B. Sensitivity and specificity were calculated, with the DSA data set as the reference standard. The sensitivity and specificity were compared with Chi-square test. Results DSA revealed 63 lesions in 27 patients, and 39 of them had blood supply. Overall sensitivity and specificity were 74. 4% （29/39） and 83.3% （20/24） for session A, and 94. 9% （37/39）, 95.8% （23/24） for session B, respectively. The sensitivity of the two reading sessions was significantly different （ X^2 = 6. 303, P 〈 0. 05 ）, while the specificity was insignificantly different （ X^2 = 2. 009, P 〉 0. 05 ） . Conclusion Compared with standard dynamic protocols, an arterial dual-energy dual-source CT scan with reconstruction of virtual nonenhanced and color overlay images enables detection of relapse and intrahepatic metastasis of HCC after TACE treatment with higher accuracy.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2011年第10期980-984,共5页
Chinese Journal of Radiology
关键词
癌
肝细胞
放射学
介入性
放射摄影术
X线计算机
Carcinoma, hepatocellular
Radiology, interventional
Tomography, X-ray computed
