肝癌TACE中半定量分析肝脏血流动力学改变的初步研究

A preliminary study on hemodynamics of liver with semi-quantitative evaluation in TACE treatment of HCC

目的半定量分析肝癌TACE前肝固有动脉DSA图像,评估血流动力学参数与碘油乳剂聚集之间的关系。方法应用Photoshop软件对肝癌TACE前的肝固有动脉DSA图像进行处理,分别在癌灶、癌旁肝组织及背景肝实质三个区域选定感兴趣区(ROI),并生成各区域ROI的时间-密度曲线(TDC),进行半定量分析,获取血流动力学参数:开始显影时间(TS)、达峰值时间(TP)、峰值强度(PV)、峰值显影持续时间(TD)、上升支斜率(Ku)及下降支斜率(Kd),对比分析TACE前后相对应的癌灶区域ROI内碘油乳剂聚集状况,分为碘油乳剂聚集良好组与不良组。结果 (1)在癌灶、癌旁肝组织、背景肝实质三个不同区域的TDC曲线上,Ku、Kd值两两之间均具有统计学差异(P<0.05);癌灶与癌旁肝组织、背景肝实质的TD、PV值之间对比均具有统计学差异(P<0.05);癌旁肝组织与背景肝实质的TD、PV值之间无统计学差异(P>0.05),而TP值的两两对比则都无统计学意义(P>0.05)。(2)在癌灶碘油乳剂聚集良好组与不良组对比中,TD、PV值均具有统计学意义,而Ku、Kd、TP值的对比则均无统计学意义(P>0.05)。结论 TD值与碘油乳剂聚集具有密切的联系,可用于TACE诊疗方案和疗效的评价。

Objective To evaluate the correlation between liver hemodynamics and lipiodol deposition by Semi-quantitative evaluation of hepatic arteriography images before interventional TACE treatments. Methods Using Photoshop software to process hepatic arteriography images before interventional TACE treatments, ROIS were drawn in cancer paracancer liver tissue and background liver tissue foci respectively to generate the TDC of each ROI. Then, each TDC was analyzed to obtain related hemodynarnics parameters： TS .TP. PV.TD.Ku and Kd. Comparative analysis of lipiodol deposition in the same ROIS before and after TACE, then divided into good and poor lipiodol deposition groups. Results （1）There was significant difference in Ku and Kd between two groups of the TDC of the cancer, pamcancer liver tissue and background liver tissue; significant difference in TD and PV also existed between the TDC of cancer and other two groups, but no significant difference existed in TP. （2）Significant difference in TD and PV existed between the good and poor lipiodol deposition groups. However no significant difference was observed in Ku.Kd and TP. Conclusion TD mainly relate to the lipiodol deposition and it could be used to evaluate the curative effect of TACE.