全肝CT灌注成像血流动力学参数对巨块型肝癌TACE疗效的评估价值

Evaluation Value of Hemodynamic Parameters of Whole Liver CT Perfusion Imaging in TACE Efficacy of Massive Liver Cancer

目的分析全肝CT灌注成像血流动力学参数对巨块型肝癌患者经动脉化疗栓塞术(transarterial chemoembolization,TACE)疗效的评估价值。方法回顾分析安阳市人民医院2022年11月至2023年7月收治的75例(98个病灶)接受TACE治疗的巨块型肝癌患者资料,所有患者术后1个月均接受肝脏CT灌注成像(hemodynamic parameters of whole liver CT perfusion imaging,HCTPI)及数字减影血管造影(digital subtraction angiography,DSA)检查,记录血流动力学参数并分析评估TACE疗效效能。结果75例患者共98个病灶,TACE术后DSA检查显示存在61个残瘤染色。HCTPI评估TACE术后疗效灵敏度、特异度、准确率分别为88.52%、94.59%、90.82%。残留病灶肝动脉灌注量(hepatic arterial perfusion,HAP)、肝动脉灌注指数(hepatic perfusion index,HPI)高于背景肝实质,门静脉灌注量(portal venous perfusion,PVP)、总肝灌注量(total liver perfusion,TLP)低于背景肝实质,差异均有统计学意义(P<0.05)。结论不同性质肝组织间HCTPI血流动力参数差异明显,巨块型肝癌患者TACE术后接受HCTPI检查有助于评估治疗效果。

Objective To analyze the evaluation value of whole liver CT perfusion imaging hemodynamic parameters for the efficacy of transarterial chemoembolization(TACE)in patients with massive liver cancer.Methods The data of 75 patients with massive liver cancer(98 lesions)who received TACE treatment in Anyang People′s Hospital from November 2022 to July 2023 were retrospectively analyzed.All patients received hemodynamic parameters of whole liver CT perfusion imaging and digital subtraction angiography 1 month after surgery.Hemodynamic parameters were recorded and the efficacy of TACE was evaluated.Results There were 98 lesions in 75 patients,and DSA examination after TACE showed 61 residual tumor staining.The sensitivity,specificity and accuracy of HCTPI were 88.52%,94.59%and 90.82%,respectively.hepatic arterial perfusion(HAP)and hepatic perfusion index(HPI)were higher than those of background hepatic parenchyma,and portal venous perfusion(PVP),total liver perfusion(TLP)were lower than those on the background liver parenchyma,with statistical significance(P<0.05).Conclusion HCTPI hemodynamic parameters differ significantly among liver tissues of different nature.HCTPI examination after TACE in patients with massive liver cancer is helpful to evaluate the therapeutic effect.