CAJ | 학술논문

目的探讨CT灌注成像(CT perfusion imaging,CTPI)在评价原发性肝癌(Primary hepatic carcinoma,PHC)行经导管动脉化疗栓塞术(Transcatheter arterial chemoembolization,TACE)后的疗效方面的价值.方法收集患有PHC并行TACE术的患者33例,病灶均为单发,所有病例于TACE术前1周及术后1个月行64排CTPI、CT增强和血管造影(Digital subtraction angiography,DSA)检查.以DSA为"金标准",对生成血流灌注伪彩图和各项灌注参数进行分析比较,评价CTPI在判断肝细胞癌介入术后的疗效方面的价值.结果术后肿瘤组织肝动脉灌注值(Hepatic arterial perfusion,HAP)、肝动脉灌注指数值(Hepatic perfusion index,HPI)和全肝总灌注量(Total hepatic blood flow,THBF)与术前相比明显减少(P＜0.01),门静脉灌注值(Portal vein perfusion,PVP)与治疗前相比无明显变化(P＞0.05),碘油沉积区及坏死区无血流灌注,时间密度曲线呈直线;周围正常肝组织的各项CTPI值与术前相比无统计学差异(P＞0.05).CTPI对PHC 行经TACE后局部残留或复发灶的诊断准确性为87.88%,灵敏度为95.83%,特异度为66.67%,与DSA相比,两者的一致性较好(kappa≥0.75).结论 CTPI能够很好地反映PHC TACE术后局部病灶和周围正常组织的血供情况,可部分代替DSA评价PHC经 TACE术后的疗效.
목적 탐토CT관주성상(CT perfusion imaging,CTPI)재평개원발성간암(Primary hepatic carcinoma,PHC)행경도관동맥화료전새술(Transcatheter arterial chemoembolization,TACE)후적료효방면적개치.방법 수집환유PHC병행TACE술적환자33례,병조균위단발,소유병례우TACE술전1주급술후1개월행64배CTPI、CT증강화혈관조영(Digital subtraction angiography,DSA)검사.이DSA위"금표준",대생성혈류관주위채도화각항관주삼수진행분석비교,평개CTPI재판단간세포암개입술후적료효방면적개치.결과 술후종류조직간동맥관주치(Hepatic arterial perfusion,HAP)、간동맥관주지수치(Hepatic perfusion index,HPI)화전간총관주량(Total hepatic blood flow,THBF)여술전상비명현감소(P＜0.01),문정맥관주치(Portal vein perfusion,PVP)여치료전상비무명현변화(P＞0.05),전유침적구급배사구무혈류관주,시간밀도곡선정직선;주위정상간조직적각항CTPI치여술전상비무통계학차이(P＞0.05).CTPI대PHC 행경TACE후국부잔류혹복발조적진단준학성위87.88%,령민도위95.83%,특이도위66.67%,여DSA상비,량자적일치성교호(kappa≥0.75).결론 CTPI능구흔호지반영PHC TACE술후국부병조화주위정상조직적혈공정황,가부분대체DSA평개PHC경 TACE술후적료효.