旋转DSA、DSA在原发性肝癌早期诊断和TACE介入治疗中的应用价值

Application of rotational DSA and conventional DSA in early diagnosis and TACE interventional therapy in primary liver cancer

目的研究旋转数字减影血管造影(DSA)、DSA在原发性肝癌早期诊断和经皮动脉化疗栓塞术(TACE)介入治疗中的应用价值。方法选取2022年1月至2023年10月我院收治的100例疑似原发性肝癌患者为研究对象,均给予常规DSA、旋转DSA检查,并以病理检查结果为金标准,比较旋转DSA、DSA在原发性肝癌中的检出结果、诊断效能、病灶检出率、临床检测情况及图像质量。76例原发性肝癌患者接受TACE介入治疗,均于术后3个月给予常规DSA、旋转DSA检查,比较2种检查方式对术后残留或复发病灶的检出率。结果以病理检查结果为金标准,旋转DSA对原发性肝癌诊断敏感度、准确度、阴性预测值高于DSA(P<0.05)。旋转DSA病灶检出率高于DSA(97.79%比87.50%,P<0.05),且旋转DSA对<1 cm的病灶检出率高于DSA(91.43%比68.57%,P<0.05)。旋转DSA造影剂剂量、辐射剂量、成像次数低于DSA(P<0.05)。旋转DSA甲级片占比高于DSA(86.00%比70.00%,P<0.05)。旋转DSA介入术后残留或复发病灶检出率高于DSA(98.55%比84.06%,P<0.05)。结论旋转DSA在微小隐匿病灶和TACE介入术后残留或复发病灶检出方面优于常规DSA,在原发性肝癌早期诊断和TACE术后疗效评估中具有重要临床价值。

Objective To investigate the application of rotational digital subtraction angiography(DSA)and conventional DSA in early diagnosis and transcatheter arterial chemoembolization(TACE)interventional therapy in primary liver cancer(PLC)Methods During January 2022 to October 2023,One hundred patients with suspected PLC and 76 PLC patients with 3-month postoperative TACE interventional therapy admitted in our hospital were enrolled in the study.All patients were managed by conventional DSA and rotational DSA examinations.The pathological parameters were used as golden standard,the diagnostic efficacy of rotational DSA versus conventional DSA was evaluated,including the detection results,diagnostic efficacy,lesion detection rate,clinical detection and image quality in primary liver cancer.In addition,The detection rates of postoperative residual or recurrent lesions were assessed between the two methods.Results The diagnostic sensitivity,accuracy,negative prediction value of rotational DSA were significantly higher than those of conventional DSA(P<0.05).The detection rates of the lesions and the lesions less than 1 cm of the rotational DSA were significantly higher than those of conventional DSA(97.79%vs 87.50%,91.43 vs 68.57,both P<0.05,respectively).The contrast dose,radiation dose,imaging frequency of the rotational DSA was significantly lower than those of conventional DSA(P<0.05).The proportion of grade A images of the rotational DSA was significantly higher than that of conventional DSA(86.00%vs 70.00%,P<0.05).The detection rates of postoperative residual and recurrent lesions of the rotational DSA was significantly higher than that of conventional DSA(98.55%vs 84.06%,P<0.05).Conclusion The effect of rotational DSA in diagnosis of small or occult lesions and residual or recurrent lesions after TACE interventional therapy is obviously better relative to conventional DSA,which can provide important reference for early diagnosis and important clinical value for PLC after TACE.