螺旋CT灌注成像与超声超微细血流成像在评估肝癌介入术后活性病灶血供中的应用比较
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摘要
目的比较螺旋CT灌注成像(CT perfusionimaging,CTPI)与超声超微细血流成像(superbmicrovascular imaging,SMI)在评估肝癌介入术后活性病灶血供中的应用价值。方法选取我院收治的48例行肝癌介入术治疗患者,均于术后6周接受螺旋CT灌注成像与超声超微细血流成像检查,以数字减影血管造影(DigitalSubtractionAngiography,DSA)为"金标准",比较CTPI与SMI评估肝癌介入术后活性病灶血供准确性。结果DSA检查显示,52枚病灶中,有血供46枚,无血供6枚;CTPI检查术后活性病灶血供灵敏度95.65%(44/46),特异度100.00%(6/6),准确性86.15%(50/52),Kappa值0.84;SMI检查术后活性病灶血供灵敏度82.61%(38/46),特异度83.33%(5/6),准确性82.69%(43/52),Kappa值0.44;CTPI检查准确性与灵敏度均明显高于SMI检查结果(P<0.05)。结论两种检查方式与DSA检查结果均具有一致性,相较于SMI,螺旋CTPI评估肝癌介入术后活性病灶血供具有较高准确性,可为患者预后判定提供有效指导。
Objective To compare the value of CT perfusion imaging(CTPI) versus superb microvascular imaging(SMI) in evaluating the blood supply of active lesions after interventional operation for liver cancer. Methods Forty-eight patients undergoing interventional operation for liver cancer were selected. They were examined with CTPI and SMI at 6 weeks after operation. With digital subtraction angiography(DSA) as the golden standard, the accuracy was compared between CTPI and SMI in evaluating blood supply of active lesions after interventional operation for liver cancer. Results DSA showed that of the 52 lesions, there were 46 lesions with blood supply and 6 lesions without.The sensitivity, specificity, accuracy and Kappa value of CTPI for blood supply of active lesions after operation were 95.65%(44/46), 100.00%(6/6), 86.15%(50/52) and 0.84,respectively, while those of SMRI were 82.61%(38/46), 83.33%(5/6), 82.69%(43/52)and 0.44, respectively. The accuracy and sensitivity of CTPI were significantly higher than those of SMI(P<0.05). Conclusion Results of the two examination methods are consistent with those of DSA. Compared with SMI, the accuracy of spiral CTPI is relatively higher in assessing the blood supply of active lesions after interventional operation for liver cancer,and it can provide effective guidance for evaluation of the prognosis of patients.
Objective To compare the value of CT perfusion imaging(CTPI) versus superb microvascular imaging(SMI) in evaluating the blood supply of active lesions after interventional operation for liver cancer. Methods Forty-eight patients undergoing interventional operation for liver cancer were selected. They were examined with CTPI and SMI at 6 weeks after operation. With digital subtraction angiography(DSA) as the golden standard, the accuracy was compared between CTPI and SMI in evaluating blood supply of active lesions after interventional operation for liver cancer. Results DSA showed that of the 52 lesions, there were 46 lesions with blood supply and 6 lesions without.The sensitivity, specificity, accuracy and Kappa value of CTPI for blood supply of active lesions after operation were 95.65%(44/46), 100.00%(6/6), 86.15%(50/52) and 0.84,respectively, while those of SMRI were 82.61%(38/46), 83.33%(5/6), 82.69%(43/52)and 0.44, respectively. The accuracy and sensitivity of CTPI were significantly higher than those of SMI(P<0.05). Conclusion Results of the two examination methods are consistent with those of DSA. Compared with SMI, the accuracy of spiral CTPI is relatively higher in assessing the blood supply of active lesions after interventional operation for liver cancer,and it can provide effective guidance for evaluation of the prognosis of patients.
引文
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[12]廖碧红,单鸿,王劲,等.肝炎后肝硬化继发肝癌患者小肝癌病灶3 2 0排CT灌注成像HAP、HPI、HPP变化及其临床意义[J].山东医药,2017,57(40):14-17.
[13]张春雨,付宇,李晓东,等.肝癌的影像学诊断进展[J].临床肝胆病杂志,2017, 33(7):1266-1269.
[14]朱炳印,郭顺林,姚永杰,等.双源CT全肝灌注成像对原发性肝细胞肝癌TACE术后疗效的评估[J].中国CT和MRI杂志,2017, 15(8):80-84.
[15]刘水清,马一博,韩宗宏等.超微细血流成像技术评价肝癌介入治疗疗效的价值[J].中华肝脏病杂志,2017, 25(7):512-516.
[16]刘丽君.螺旋CT灌注成像对肝细胞型肝癌与局灶性结节增生的鉴别诊断[J].中国医药导报,2016,13(22):117-120.
[2]姜昊,隋广平,姜慧杰.CT灌注成像对肝癌相关生物学特性及治疗疗效的评价价值[J].中华医学杂志,2016, 96(27):2206-2208.
[3]李春晖,徐丽丽,张雪棉,等.72例老年原发性肝癌患者病灶超声造影特点分析[J].山东医药,2 017,57(24):53-55.
[4]Bruix J,Sherman M. Management Of Hepatocellular Carcinoma[J].Hepatology,2005, 42(5):1208-1236.
[5]苏赞瑞,黄运福,林建军,等. DSA和钆塞酸二钠增强MR I对肝癌术后复发微小病灶诊断的比较研究[J].介入放射学杂志,2017, 26(6):559-563.
[6]朱炳印,郭顺林,姚永杰,等.CT灌注成像在原发性肝癌的临床应用价值[J].中国CT和MRI杂志,2017,15(3):145-148.
[7]陈宏.多层CT灌注技术在鉴别肝肿瘤病变的临床价值[J].中国CT和MRI杂志,2017, 15(3):82-84.
[8]梁长华,毛华杰,岳军艳,等.肝细胞肝癌CT全肿瘤灌注测量值与MVD及其与病理分化程度的相关性[J].实用癌症杂志,2017, 32(9):1401-1405.
[9]毛卫霞,贾喆. 64排螺旋CT灌注成像PS、BV对肺癌及肺良性肿物的诊断价值[J].实用癌症杂志,2017,32(11):1909-1910.
[10]周玉刚,余成洲,刘锡群. CT灌注成像在肝癌患者中的应用价值研究[J].海南医学院学报,2016,22(9):883-885.
[11]刘月军,刘向东.双源螺旋CT多时相灌注成像在诊断原发性小肝癌中的价值研究[J].肝脏,2 017,22(4):373-374.
[12]廖碧红,单鸿,王劲,等.肝炎后肝硬化继发肝癌患者小肝癌病灶3 2 0排CT灌注成像HAP、HPI、HPP变化及其临床意义[J].山东医药,2017,57(40):14-17.
[13]张春雨,付宇,李晓东,等.肝癌的影像学诊断进展[J].临床肝胆病杂志,2017, 33(7):1266-1269.
[14]朱炳印,郭顺林,姚永杰,等.双源CT全肝灌注成像对原发性肝细胞肝癌TACE术后疗效的评估[J].中国CT和MRI杂志,2017, 15(8):80-84.
[15]刘水清,马一博,韩宗宏等.超微细血流成像技术评价肝癌介入治疗疗效的价值[J].中华肝脏病杂志,2017, 25(7):512-516.
[16]刘丽君.螺旋CT灌注成像对肝细胞型肝癌与局灶性结节增生的鉴别诊断[J].中国医药导报,2016,13(22):117-120.