经动脉化疗栓塞联合索拉非尼治疗肝癌的肝动脉血流动力学 DSA 图像

Hepatic arterial hemodynamics obtained from DSA images in patients with hepatocellular carcinoma treated by TACE plus sorafenib: a preliminary study

目的探讨经动脉化疗栓塞(TACE)联合索拉非尼治疗肝癌后短期内的肝动脉DSA血流动力学表现。方法回顾性分析30例TACE治疗肝癌病例,其中治疗组13例,对照组17例。治疗组除接受TACE治疗外,还在治疗前1周、或治疗后2周内开始口服索拉非尼400 mg每日2次。对照组只给予TACE治疗。分析患者第1次和3个月后TACE治疗的DSA图像。用Photoshop软件在动态系列DSA图像上测量肿瘤的染色灰度,并绘制肿瘤染色的时间-密度曲线。比较两组患者肿瘤染色的峰值强度(PV),达峰值时间(TP)和曲线上升支斜率(SU)。结果 Photoshop软件可以测量DSA图像中肿瘤组织的染色灰度。治疗组治疗后的染色PV小于治疗前(分别为38.0±14.6和46.7±18.4,P=0.040)、也小于对照组治疗后的染色PV(分别为38.0±14.6和54.4±19.8,P=0.011)。两组之间以及每组治疗前后的TP和SU差异无统计学意义。结论 TACE联合索拉非尼治疗肝癌后短期内的肝动脉DSA肿瘤染色峰值下降。

Objective To investigate DSA- estimated hepatic arterial hemodynamics of hepatocellular carcinoma （HCC） determined shortly after transcatheter arterial chemoembolization （TACE） plus sorafenib treatment. Methods The clinical data of thirty HCC patients treated with TACE were retrospectively analyzed. The patients were divided into study group （n = 13） and control group （n = 17）. Patients in the study group received additional oral administration of 400mg sorafenib twice a day one week before or two weeks after TACE procedure, while patients in the control group received TACE only. The initial DSA images as well as the images obtained at three months after TACE were analyzed. With the help of Photoshop software, the grey gradient of the tumor staining was measured on the series dynamic DSA images, based on which the time- density curve of the tumor was drawn. The peak density value （PV）, the time to reach the peak （TP） and the slope of the upslope （SU） were determined, and the results were compared between the two groups. Results Photoshop software was used to measure the grey density values of the tumor staining on DSA images. In the study group, the post- treatment PV was smaller than the pre- treatment one, which were （38.0 ± 14.6） and （46.7 ± 18.4） respectively, the difference between the two groups was statistically significant （P = 0.040）. The post- treatment PV of the study group was also smaller than that of the post -treatment PV of the control group （54.4 ± 19.8）, and the difference between the two was also statistically significant （P = 0.011）. No significant differences in TP values and SU values existed between the two groups as well as between the pre - treatment and post - treatment ones in each group. Conclusion After TACE.