CAJ | 학술논문

目的：通过超声造影与增强 CT 在肝癌行肝动脉化疗栓塞术（TACE）后的影像对照研究，探讨超声造影在肝癌 TACE 后评估中临床价值。方法：对42例行 TACE 后的原发性肝癌患者，术后一个月分别行超声造影、增强 CT 检查，之后行 DSA 检查，有未栓塞完全病灶再次行 TACE，之后将二者的检查结果与术中 DSA 结果进行对照研究，分析超声造影的特征。结果：行 DSA 造影后，41名患者行 TACE，1名患者未行 TACE。而增强 CT 示36例患者的病灶栓塞不完全，有强化表现，需要再次行 TACE，敏感度为87．8％，特异度为100％，阳性预测值为100％，阴性预测值为16．7％，准确度为88．1％。超声造影示40例患者病灶栓塞不完全，有强化表现，需要再次进行 TACE，敏感度为97．6％，特异度为100％，阳性预测值为100％，阴性预测值为50％，准确度为97．6％。两组检查结果无统计学差异（P ＞0．05）。结论：超声造影检查结果的准确度高于增强 CT 检查结果，接近 DSA 检查结果，可以应用于肝癌行 TACE 后的评价。
목적：통과초성조영여증강 CT 재간암행간동맥화료전새술（TACE）후적영상대조연구，탐토초성조영재간암 TACE 후평고중림상개치。방법：대42례행 TACE 후적원발성간암환자，술후일개월분별행초성조영、증강 CT 검사，지후행 DSA 검사，유미전새완전병조재차행 TACE，지후장이자적검사결과여술중 DSA 결과진행대조연구，분석초성조영적특정。결과：행 DSA 조영후，41명환자행 TACE，1명환자미행 TACE。이증강 CT 시36례환자적병조전새불완전，유강화표현，수요재차행 TACE，민감도위87．8％，특이도위100％，양성예측치위100％，음성예측치위16．7％，준학도위88．1％。초성조영시40례환자병조전새불완전，유강화표현，수요재차진행 TACE，민감도위97．6％，특이도위100％，양성예측치위100％，음성예측치위50％，준학도위97．6％。량조검사결과무통계학차이（P ＞0．05）。결론：초성조영검사결과적준학도고우증강 CT 검사결과，접근 DSA 검사결과，가이응용우간암행 TACE 후적평개。
Objective:By Control study of contrast enhanced ultrasound and contrast enhanced CT in the image of hepatocellular carcinoma after TACE,to investigate the clinical value of contrast -enhanced ultrasound in the evalua-tion in hepatocellular carcinoma after TACE.Methods:The 42 cases with hepatocellular carcinoma that were done TACE after one month were performed contrast enhanced ultrasound,enhanced CT and DSA examination.The lesions were not embolized completely needed undergo TACE again.After the two examination results and intraoperative DSA findings were compared,and analyzed the characteristics of contrast enhanced ultrasound.Results:There were 41 pa-tients performed TACE and 1 patient without TACE after DSA.Enhanced CT showed 36 cases had incomplete embol-ism with a performance enhancement and needed a second TACE.The sensitivity was 87.8%,specificity was 100%, the positive predictive value was 100%,the negative predictive value was 16.7% and the accuracy was 88.1%.Con-trast enhanced ultrasound showed 40 cases had incomplete embolism with a performance enhancement and needed a second TACE.The sensitivity was 97.6%,the specificity was 100%,positive predictive value was 100%,negative predictive value was 50% and the accuracy was 97.6%.The data of two groups were not statistically significant (P >0.05).Conclusion:Accuracy of examination results in contrast enhanced ultrasound was higher than that in enhanced CT and closed to the results of DSA examination.Contrast enhanced ultrasound could be applied to hepatocellular car-cinoma after TACE.