CT灌注成像结合全肝增强扫描对41例中晚期肝癌患者行TACE疗效的评价-论文.pdf

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1、·1734·床放射学杂志2013年第32卷第12期腹部放射学CT灌注成像结合全肝增强扫描对41例中晚期肝癌患者行TACE疗效的评价何二霞，聂忠仕，朱明月，林海锋，王琳，张英辉，林志东，李孟森【摘要】目的评价cT灌注成像结合全肝增强扫描在中晚期肝癌患者行导管动脉化疗栓塞术(TACE)疗效的价值。方法4l例中晚期肝癌患者行TACE术后4周再行CT灌注扫描，计算肝血流量、肝血容量、平均通过时间、肝动脉分数及表面通透性等参数及基线图像，并于灌注扫描后即行全肝增强扫描。结果根据肝癌行TACE术后基线图像显示碘油

2、在肿瘤区域的沉积形态，观察到在41患者中，碘油完全填充型1例、缺损型或环形10例、簇集型25例及稀少型5例；与肝癌再次行TACE治疗时肝动脉数字减影血管造影结果比较，两者诊断吻合率100％。各灌注参数显示碘油沉积区域肝癌组织血流灌注消失；非碘油沉积区域与正常肝组织比较，肝血流量、肝血容量及平均通过时间等参数差异均有统计学意义(P<0．01)，而肝动脉分数及表面通透性等参数差异无统计学意义(P>0．05)。观察结果显示，全肝增强扫描可弥补CT灌注成像覆盖范围较小，无法全面了解全肝碘油填充情况的缺点；全肝

3、增强扫描可提供肝癌及子灶大小、形态、密度、强化程度以及扫描范围其他脏器有无异常，是否有腹腔淋巴结转移等详细的临床资料。结论CT灌注成像结合全肝增强扫描可判断中晚期肝癌患者行TACE疗效，对进一步治疗中晚期肝癌具有重要的临床指导价值。【关键词】中晚期肝癌经导管动脉化疗栓塞术CT灌注成像全肝增强扫描CTPerfusionImagingCombinedwithWholeLiverEnhancementScannedinEvaluatingCurativeEffectOf41PatientsHarborMid

4、AdvancedStageLiverCancerAfterTACEHEErxia，NIEZhongshi，ZHUMingyue，eta1．DepartmentofTumorInternalMedicine，HainanNongkenHosptial，Haikou，HainanProvince570311．P．R．China【Abstract】ObjectiveToevaluatedthevalueofperfusionimagingcombinedwithenhancementscannedofwho

5、leliverinpatientswithharboredmidadvancedstagelivercanceraftertransarterialchemoembolization(TACE)treatment．Meth-ods41patientswithharboredmidadvancedstagelivercancerunderwentCTperfusionimagingandwholeliverenhance—mentscanbeforeand4weeksafterTACEtreatment

6、．Hepaticbloodflow(HBF)，Hepaticbloodvolume(HBV)，Meantransittime(MTY)，Hepaticarteryfraction(HAF)，Permeabilityofsurface(PS)parameters，andthebaselineimage(BI)ofCTwereanalyzed．ResultsAccordingtotheBIofCTSCanafterperformedTACEindicatediodizedoildepositioninle

7、sions，theiodizedoildepositionconfigurationappearedentirenessfillingin1case，ringformorincompletefillingin10cases，clusterin25cases，andsparsityin5cases．CTPerfusionparametersshowedthatthebloodflowdisappearedinio—dizedoildepositioninallthepatients．HBF、HBVand

8、MTTreducedsignificantlyinnoniodizedoildepositedregioncon-paredwithnormallivertissue(P<0．01)，whileHAFandPThasnodifferencebetweennoniodizedoildepositedregionandnormallivertissue(P>0．05)．Enhancementscanofwholelivermightcompensatethe