CT灌注成像评价肝癌TACE后血流动力学改变的临床研究

CT perfusion imaging in the evaluation of hemodynamics changes of hepatocellular carcinoma after TACE

目的:研究CT灌注成像在评价肝癌TACE术后血流动力学改变中的价值。方法:本组60例肝癌患者TACE术前行CT灌注成像扫描,其中43例接受肝癌TACE治疗后行CT灌注扫描。应用去卷积算法,计算肝血流量(BF)、血容量(BV)、平均通过时间(MTT)、肝动脉灌注指数(HAP)、毛细血管表面通透性(PS)等。根据各灌注参数值及其各参数伪彩功能图、BI图评价肝癌TACE术后血流动力学改变。结果:全部受试者均按要求完成检查。基线图像(BI)显示TACE术后肝癌区域碘油沉积形态完缺损型或环形35例,簇集型8例。BF、BV、MTT、HAF灌注图显示肝癌病灶内碘油沉积区为低灌注区,肝癌组织非碘油沉积区为对比背景肝组织为不同程度高灌注区。肝癌在TACE术后,BF、BV和HAP值较肝癌TACE术前减少,而MTT和PS值在肝癌TACE术前、术后无显著性差异。结论:肝脏CT灌注成像BI图、肝脏灌注参数(BF、BV和HAP)可有效的评价TACE术后肝癌组织的血流灌注改变,具有重要的临床应用价值。

Objective To research CT perfusion imaging in the evaluation of hemodynamies changes of hepatocellular carcinoma after TACE. Method Total 60 patients with hepatocellular carcinoma performed CT perfusion image, 43 cases of them received TACE and then performed CT perfusion image later. Using deconvolution method to calculate perfusion indexes such as BF, BV, MTF, HAP, PS, et al. The hemodynamics changes of hepatocellular carcinoma after TACE were evaluated according to the perfusion indexes and the parameters of pseudo -color map and baseline images （BI）. Results BI showed that 35 cases got lipiodol deposition form defect or ring, and 8 cases got lipiodol deposition form the cluster. BF, BV, MTT, HAF perfusion maps showed liver cancer lesions in the area for the deposition of iodized oil were hypoperfusion, HCC with non - iodized oil deposition zone area contrast background liver tissue were hyperperfusion. BF, BV and HAP of hepatocellular carcinoma after TACE were lower than those of hepatocellular carcinoma, but no statistically significant differences were found in MTT and PS of hepatocellular carcinoma and those of hepatocellular carcinoma after TACE. Conclusion BI image and liver perfusion indexes （ BF, BV and HAP） can effectively evaluate the perfusion changes of hepatocellular carcinoma after TACE.