摘要
目的探讨增强CT及增强MRI的图像融合技术在原发性肝癌(肝癌)治疗决策中的作用。方法回顾性分析2013年1月至2015年1月在中山大学附属第三医院接受诊治的55例肝癌患者临床资料。男42例,女13例;年龄18~84岁,中位年龄52岁。患者均签署知情同意书,符合医学伦理学规定。所有患者行增强CT扫描和钆塞酸二钠(Gd-EOB-DTPA)增强MRI扫描,采用基于有限元的柔性配准方法融合CT和MRI图像。由肝癌多学科会诊平台对患者的治疗决策进行讨论决定,每例患者进行2次讨论,首次基于增强CT图像,第2次基于融合图像。观察并分析治疗决策变更。结果基于增强CT图像的治疗决策包括根治性治疗8例、姑息性手术治疗35例、全身性药物治疗12例。基于融合图像的治疗决策包括根治性治疗4例、姑息性手术治疗36例、全身性药物治疗15例。基于融合图像的治疗决策较基于增强CT图像在根治性治疗、姑息性手术治疗、全身性药物治疗的转换率分别为50%(4/8)、3%(1/35)、25%(3/12)。结论增强CT和Gd-EOB-DTPA增强MRI的图像融合技术改变了部分肝癌患者的治疗决策,对优化治疗方案有一定的价值。
Objective To explore the effect of enhanced CT and enhanced MRI image fusion technique in making treatment decisions for primary liver cancer （PLC）. Methods Clinical data of 55 patients with PLC who were treated in the Third Affiliated Hospital of Sun Yat-sen University between January 2013 and January 2015 were analyzed retrospectively. There were 42 males and 13 females, aged from 18-84 and with a median age of 52 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. All the patients underwent enhanced CT and gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid （Gd-EOB-DTPA） enhanced MRI. CT and MR/images were fused by using flexible registration method based on finite element. Treatment decisions for these patients were discussed and made by HCC multidisciplinary consultation group. Discussion was conducted twice for each patient. The first discussion was based on enhanced CT images and the second was based on fused images. Changes of treatment decisions were observed and analyzed. Results Treatment decisions based on enhanced CT images included radical treatment in 8 cases, palliative surgical treatment in 35 cases and systemic medicine treatment in 12 cases. Treatment decisions based on fused images included radical treatment in 4 cases, palliative surgical treatment in 36 cases and systemic medicine treatment in 15 cases. Compared with those based on enhanced CT images, the conversion rate of radical treatment, palliative surgical treatment and systemic medicine treatment based on fused images was respectively 50%（4/8）, 3%（1/35） and 25%（3/12）. Conclusions Enhanced CT and Gd-EOB-DTPA enhanced MRI image fusion can change the treatment decisions for some patients with HCC, and it is of certain significance in optimizing the treatment protocols.
出处
《中华肝脏外科手术学电子杂志》
CAS
2018年第1期53-56,共4页
Chinese Journal of Hepatic Surgery(Electronic Edition)
基金
国家自然科学基金(81572368)
广东省自然科学基金(2016A030313278
2016A030313302
2014A030313146)
广东省科技计划项目(2014A020212084)
关键词
肝肿瘤
体层摄影术
磁共振成像
钆塞酸二钠
图像融合
Liver neoplasms
Tomography
Magnetic resonance imaging
Gadolinium ethoxybenzyl diethyle-netriaminepentaacetic acid
Image fushion
