第二代双源CT低剂量全肝灌注扫描对原发性肝癌TACE血供变化的临床研究

Evaluatio of Blood Supply of Primary Liver Cancer Transcatheter Arterial Chemoembolization with Low dose Whole Liver Perfusion by the Second Generation of Dual-source CT

目的探究第二代双源CT低剂量全肝灌注扫描对原发性肝癌TACE术前、术后血供变化的评价作用。方法选择本院2017年3月至2017年11月收治的60例原发性肝癌患者,随机分为A组和B组,各30例。两组采用不同KV值、mAs值进行扫描,A组KV值维持在100 kv,mAs值降至80分别于TACE术前3～7 d、术后30～35 d行常规肝脏三期增强扫描;B组KV值降至80 kv,mAs值降至110分别于TACE术前3～7 d、术后30～35 d行低剂量CT灌注扫描。结果 A组TACE术前、术后HBF、HBV、ALP、HPI灌注指标比较差异有统计学意义(P<0.05);B组TACE术前、术后TTP的灌注指标比较差异有统计学意义(P<0.05);A组低剂量与常规增强辐射剂量、预设辐射剂量均比较差异有统计学意义(P<0.05),B组低剂量与常规增强辐射剂量比较差异无统计学意义,与预设辐射剂量比较差异有统计学意义(P<0.05)。结论第二代双源CT低剂量全肝灌注扫描不仅可以获得满意的全肝低剂量灌注图,还可以充分显示原发性肝癌TACE术前、术后的血供变化。

Objective Explore the effect of low dose whole liver perfusion by the second generation of dual-source CT in evaluating blood supply changes before and after TACE for Primary Liver Cancer.Methods 60 patients with primary liver cancer in our hospital from March 2017 to November 2017 were randomly divided into group A and group B,There were 30 cases in each group.The two groups were scanned with different KV values and mAs values.In group A,The KV value was maintained at 100 kV and the mAs value was reduced to 80.Three-phase contrast-enhanced liver scan was performed 3-7 d before TACE and 30-35 d after TACE,In group B,KV and mAs decreased to 80 kV and 110 low-dose CT perfusion scans were performed 3-7 d before TACE and 30-35 d after TACE.Results HBF,HBV,ALP and HPI perfusion indexes in group A were significantly different before and after TACE(P<0.05).The perfusion index of TTP in group B was significantly different before and after TACE(P<0.05).There were significant differences between low dose and conventional enhanced radiation dose and preset radiation dose in group A(P<0.05).In group B,The difference between low dose and conventional enhanced radiation dose was not statistically significant.There was a significant difference between the radiation dose and the preset radiation dose(P<0.05).Conclusion The second generation dual source CT low dose whole liver perfusion scan can not only obtain satisfactory whole liver low dose perfusion map,but also fully display the changes of blood supply before and after TACE for primary hepatocellular carcinoma.