能谱CT预测肝癌TACE术后碘油沉积情况的初步研究

The Value of Energy Spectral CT in Predicting Lipiodol Accumulation of Hepatocellular Carcinoma After TACE

目的探讨能谱CT物质定量分析与肝癌TACE术后碘油沉积情况的相关性及其临床价值。方法对28例原发性肝癌患者TACE术前进行能谱CT扫描,术后1个月CT复查。利用能谱分析软件(GSI)对术前能谱图像进行后处理,用混合能量和单能量图像对病灶进行观察,分别记录动脉期、静脉期肿瘤病灶碘基值及对比术后复查图像病灶碘油沉积区域和无碘油沉积区域术前碘基值、腹主动脉和门静脉碘基值。结果术后仅1例病灶碘油完全沉积。术后碘油沉积面积>50%病灶的术前动脉期标准化碘浓度(ANIC)较术后碘油沉积面积<50%的病灶高,分别为0.25±0.04、0.18±0.06(P<0.01),标准化碘浓度比率(ICratio)及静脉期标准化碘浓度(VNIC)差异无统计学意义。同一病灶碘油沉积区域动脉期标准化碘浓度(ANIC)较无碘油沉积区域高,分别为0.21±0.05、0.16±0.06(P<0.01)。结论利用能谱CT测得的动脉期标准化碘基值可以较好的预测TACE术后肝癌病灶碘油沉积情况,从而对评价肝癌预后及为TACE术筛选合适病例提供一定参考。

Objective To evaluate the correlation between quantitative analysis of spectral CT and lipiodol accumulation of HCC after TACE. Methods 28 HCC patients who underwent three-phase Spectral CT before TACE procedure were retrospectively analysed. Spectral parameters of Iodine concentration and IC ratio were obtained by Spectral CT. The relationship of Iodine concentration and IC ratio between the groups were compared. Results Complete accumulation of lipiodol was found in only one case. The values of ANIC with satisfied accumulation of iodized oil were obviously higher than those in lesions with unsatisfied accumulation. No differences of IC ratios and VNIC were found between the groups. Moreover,in the same lesions,parts of HCC with preferable accumulation of iodized oil have higher ANIC values than parts without accumulation. Conclusion Iodine concentration obtained by Spectral CT could be a useful method to predict lipiodol accumulation of HCC after TACE.