CT肝脏灌注成像对PHC患者TACE术后血流状态的评估

Evaluation of Blood Flow Status after TACE in PHC Patients by CT Liver Perfusion Imaging

本文采用CT肝脏灌注成像对原发性肝癌(PHC)血供特点进行观察并评价肝动脉化疗栓塞术(TACE)后血流灌注状况。选取70例经肝活检证实为PHC的患者为研究对象,均进行TACE治疗,TACE干预前后进行CT肝脏灌注成像并评估效果,分析CT肝脏灌注成像对PHC患者短期疗效的价值。与非瘤区组织相比,肿瘤活性灶肝血流量(HBF)、肝动脉灌注指数(HPI)、肝动脉灌注量(HAP)较高,达峰时间(TTP)较低(P<0.05)。与无效患者相比,有效患者微血管密度(MVD)、血管内皮生长因子(VEGF)较低(P<0.05)。与干预前相比,干预后HBF、HPI、HAP较低,TTP较高(P<0.05)。HBF、HPI、HAP及TTP联合诊断的AUC为0.940(P<0.05),对PHC患者近期疗效的诊断效能较高(P<0.05)。CT肝脏灌注成像有助于评估患者PHC患者TACE术后血流状态,临床价值较高。

In this study,the blood supply characteristics of primary hepatic carcinoma(PHC)were observed by CT liver perfusion imaging,and the blood perfusion after tanscatheter arterial chemoembolization(TACE)was evaluated.Seventy patients confirmed as PHC by liver biopsy were selected for TACE treatment,and CT liver perfusion imaging was performed before and after TACE intervention to evaluate the effect,and analyze the value of CT liver perfusion imaging for short-term efficacy in PHC patients.Compared with non-tumor tissues,the hepatic blood flow(HBF),hepatic artery perfusion index(HPI),hepatic artery perfusion(HAP)in tumor active lesions were higher,and the time to peak(TTP)was lower(P<0.05).Compared with ineffective patients,microvascular density(MVD)and vascular endothelial growth factor(VEGF)were lower in effective patients(P<0.05).Compared with the before intervention,HBF,HPI and HAP were lower and TTP was higher after intervention(P<0.05).The AUC of HBF,HPI,HAP and TTP combined diagnosis was 0.940(P<0.05),and the diagnostic efficiency of short-term efficacy in patients with PHC was higher(P<0.05).CT liver perfusion imaging is helpful in assessing the postoperative blood flow status after TACE in patients with PHC,with high clinical value.