CT灌注成像在肝癌TACE术后评估中的应用

Evaluation of CT perfusion imaging to hepatocellular carcinoma after transcatheter arterial chemoembolization with olipidol

目的探讨CT灌注成像在肝癌TACE术后活性灶评估中的应用价值。方法30例行TACE治疗的肝癌患者,术后均行肝脏CT平扫、CT灌注成像及常规肝增强扫描并以三者作为术后影像学随访的手段。根据灌注扫描所得图像自动生成时间-密度曲线(TDC),计算灌注参数。包括:血流量(BF)、血容量(BV)、对比剂的平均通过时间(MTT)、毛细血管通透性(PS)和肝动脉指数(HAI)。以再次肝动脉造影结合临床随访作为"诊断金标准"进行临床诊断试验与评价。结果TACE术后肝癌活性灶与非瘤区肝组织的BF,BV,MTT,HAI具有显著统计学差异(P<0.05)。PS无显著统计学差异(P>0.50)。CTP的诊断正确率=91.07%;灵敏度=95.74%;特异度=66.67%;阳性预测值=93.81%;阴性预测值=75.00%;阳性似然比=2.74;阴性似然比=0.13;Youden指数=57.82%。结论CT灌注成像在肝癌TACE术后活性灶评估中具有较高的应用价值。

Objective To evaluate 16 multi-slice spiral CT perfusion imaging （CTPI） in the following up of hepatocellular carcinoma （HCC）after transcatheter arterial chemoembolization （TACE）. Methods Thirty patients suffered from HCC after TACE underwent multi-slice spiral CTPI, and the outcomes were compared with DSA or pathologic findings. Results CTPI had the accuracy of 91.07%, sensitivity of 95.74%, specificity 66.67% and Youden＇s index of 57.82% in detecting the newborn blood supplies and/or the residual blood supplies. Conclusion Multi-slice CTPI is a noninvasive evaluating and following up method for HCC after TACE.