多层螺旋CT评估肝癌射频消融术后肿瘤灭活的临床价值

Research on the clinical value of tumor deactivation after radiofrequency ablation of liver cancer assessed by MDCT

目的:探讨多层螺旋CT评估肝癌射频消融(RFA)术后肿瘤灭活的临床价值。方法:采用CT灌注成像(CTP)联合CT动脉成像(CTA)及CT增强扫描评价91例肝癌患者行RFA术治疗前后肿瘤的大小、密度变化及凝固性坏死区范围,比较两种评价方法诊断肿瘤复发或残余的灵敏度、特异度和准确率。结果:CTP联合CTA诊断肿瘤复发或残余的灵敏度、特异度和准确率分别为100%、95.3%和96.2%;常规增强CT分别为33.3%、88.4%和78.8%。RFA治疗后肿瘤复发或残余的诊断灵敏度、准确率CTP联合CTA高于常规增强CT,差异有统计学意义(x^2=6.912,x^2=7.121;P<0.05);特异度之间两者差异无统计学意义(x^2=0.615,P>0.05)。结论:CTP联合CTA可准确地判断RFA后肿瘤有无灭活及程度,且优于常规增强CT,是RFA有效与否的有效评估方法,具有较高临床价值。

Objective： To explore the clinical value of tumor deactivation after radiofrequency ablation of liver cancer assessed by MDCT. Methods： By CT perfusion combined with CT angiography and CT enhanced scan in 91 cases of liver cancer patients before and after radiofrequency ablation treatment, the change of tumor size, density change, scope of coagulation necrosis area and comparison sensitivity, specificity and accuracy of two methods diagnosis of recurrent or residual tumor were observed. Results： In the diagnosis of tumor recurrence or residual degree of sensitivity, specificity and accuracy CTP combine CTA were 100%, 95.3%, 96.2%, conventional enhanced CT were 33.3%, 88.4% and 78.8%. The diagnosis of recurrence or residual tumor after radiofrequency sensitivity and accuracy CTP combine CTA is higher than conventional enhancement CT, The difference was statistically significant（x2=6.912, x2=7.121; P〈0.05）. Both no statistical difference between specificity（x2=0.615, P〈0.05）.Conclusion： CTP combination CTA can accurately determine the tumor after radiofrequency ablation for inactivated and degree, and superior to the conventional enhanced CT, is an effective evaluation method of radiofrequency ablation with a high clinical value.