摘要
目的 对比分析CT增强扫描和数字减影血管造影（DSA）对原发性肝癌（PHC）经导管肝动脉化疗栓塞术（TACE）治疗后肿瘤残留及新发病灶（复发）的显示情况.方法 选择自2010年6月至2013年2月就诊的、临床资料及影像学资料完整的、确诊为PHC并接受TACE治疗的患者共60例.对比分析CT和DSA对TACE治疗后肿瘤残留及新发病灶检出的敏感性和特异性,分析检出率偏低的主要影响因素.结果 60例患者有86个病灶,CT增强检查对肿瘤复发的检出率为57.0％（49/86）,DSA检查的检出率为67.4％（58/86）.以DSA为金标准,CT增强扫描判断病灶复发的敏感度为84.5％（49/58）,特异度为100.0％（28/28）,假阴性率为15.5 ％（9/58）,准确率为89.5％（77/86）.CT增强扫描和DSA检查对判断肿瘤复发差异有统计学意义（P＜0.05）,DSA检查对肿瘤复发的检出率优于CT增强检查.结论 CT三期动态增强扫描是PHC TACE术后复查的首选随访检查方法,但多种因素会影响残留及新发病灶的显示,DSA检查对肿瘤复发的检出率优于CT增强检查,临床高度怀疑复发但CT增强检查阴性时需行DSA检查,以免延误治疗.
Objective To comparative analyze the CT enhanced scan and digital substraction angiography （DSA） in showing the residual and new lesions after treatment of transcatheter arterial chemoembolization （TACE）. Methods 60 cases of patients with complete clinical information and imaging data from June 2010 to February 2013 were collected, these patients were diagnosed of primary hepatocelluar carcinoma and underwent TACE treatment. The sensitivity and specificity of CT and DSA to detect the residual and new lesions after TACE treatment were analyzed. By aqalysis of the main factors affecting the low detection rate to seek a method that can improve PHC residual new lesions detection rate after TACE. Results There were 86 lesions in 60 cases, CT enhanced scan clearly determined the diagnosis of 49 lesions （42 residues, 7 new lesions）. 37 lesions did not prompted to tumor recurrence （residual and new lesions）. DSA as the goldstandard, the sensitivity of CT enhanced scan to check out the lesions was 84.5 % （49/58）, specificity was 100.0 % （28/28）, the false negative rate was 15.5 % （9/58）, the accuracy was 89.5 % （77/86）. Enhanced CT detection rate of tumor recurrence was 57.0 % （49/86）, the DSA detection rate of tumor recurrence was 67.4 % （58/86）. The difference of determining tumor recurrence between the CT enhanced scan and DSA was significant （X2 = 7.11, P 〈 0.05）. Conclusions Three dynamic contrast-enhanced CT scan is the first choice for follow-up examination methods after TACE for hepatocellular carcinoma, but many factors will affect the detection rate of the residual and new lesions. Compared with CT examination, DSA examination has more advantages. DSA examination should be performed when the clinical suspicion of tumor recurrence is negative after enhanced CT scan.
出处
《肿瘤研究与临床》
CAS
2014年第3期145-147,152,共4页
Cancer Research and Clinic
关键词
肝肿瘤
化学栓塞
治疗性
体层摄影术
计算机
血管造影术
数字减影
Liver neoplasms
Chemoembolization, therapeutic
Tomography, computed
Angiography, digital subtraction
