多层螺旋CT灌注参数评价肝癌经动脉化疗栓塞术后疗效
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摘要
目的:探讨多层螺旋CT(MSCT)灌注参数在肝癌行经动脉化疗栓塞术(TACE)后疗效评价中的应用。方法:选择松滋市人民医院2015年1月至2016年12月期间收治的肝癌患者94例。所有患者均采用Seldinger股动脉穿刺置管,行数字减影血管造影和TACE治疗,且术前和术后进行MSCT检查。结果:MSCT扫描碘油沉积情况肿块型I型少于结节型(18/54 vs 28/40),II型多于结节型(30/54 vs 10/40),均有统计学差异(P<0.05);III型和IV型比较无统计学差异(P>0.05);肿块型和结节型患者治疗总有效率分别为90.74%(49/54)和92.50%(37/40)。结论:MSCT灌注参数可用于肝癌行TACE术后疗效评价,具有较好的临床应用价值。
Objective To investigate the application of multi-slice spiral computed tomography(MSCT) perfusion parameters in evaluating the therapeutic effect of transcatheter arterial chemoembolization(TACE) in patients with hepatocellular carcinoma(HCC). Methods Ninety-four patients with HCC admitted to Songzi People's hospital from January 2015 to December 2016 were selected. All patients were treated with Seldinger femoral artery catheterization, underwent digital subtraction angiography and TACE, and received MSCT in the preoperative and postoperative examinations. Results The lipiodol deposition in MSCT scan revealed that for type I, the number of mass type was less than that of nodular type(18/54 vs 28/40, P<0.05), while for type II, the number of mass type was more than that of nodular type(30/54 vs 10/40, P<0.05).No statistical differences were found in type III and type IV(P>0.05). The total effective rates of mass and nodular HCC were 90.74%(49/54) and 92.50%(37/40), respectively. Conclusion MSCT perfusion parameters can be used to evaluate the efficacy of TACE in patients with HCC, with good application value in clinic.
Objective To investigate the application of multi-slice spiral computed tomography(MSCT) perfusion parameters in evaluating the therapeutic effect of transcatheter arterial chemoembolization(TACE) in patients with hepatocellular carcinoma(HCC). Methods Ninety-four patients with HCC admitted to Songzi People's hospital from January 2015 to December 2016 were selected. All patients were treated with Seldinger femoral artery catheterization, underwent digital subtraction angiography and TACE, and received MSCT in the preoperative and postoperative examinations. Results The lipiodol deposition in MSCT scan revealed that for type I, the number of mass type was less than that of nodular type(18/54 vs 28/40, P<0.05), while for type II, the number of mass type was more than that of nodular type(30/54 vs 10/40, P<0.05).No statistical differences were found in type III and type IV(P>0.05). The total effective rates of mass and nodular HCC were 90.74%(49/54) and 92.50%(37/40), respectively. Conclusion MSCT perfusion parameters can be used to evaluate the efficacy of TACE in patients with HCC, with good application value in clinic.
引文
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[13]王雨,唐腾骞,张辉,等.CT及多层螺旋CT对索拉菲尼治疗原发性肝癌前后的评判对比研究[J].肿瘤药学,2016,6(6):451-455.WANG Y,TANG T Q,ZHANG H,et al.A study of CT in monitoring the effects of sorafenib on primary hepatic carcinoma[J].Anti-tumor Pharmacy,2016,6(6):451-455.
[14]马冬,罗娅红,郑文恒,等.256多层螺旋CT一站式扫描在原发性肝癌中的应用[J].肿瘤学杂志,2015,21(10):839-842.MA D,LUO Y H,ZHEN W H,et al.The application of 256 rows of one-stop CT scan in primary hepatic cancer[J].Journal of Chinese Oncology,2015,21(10):839-842.
[15]李保全,赵宏伟,白雪峰.肝硬化合并小肝癌与肝硬化再生结节多层螺旋CT灌注成像分析[J].实用医药杂志,2014,31(11):1000-1001.LI B Q,ZHAO H W,BAI X F.Multislice spiral CT perfusion imaging analysis of cirrhosis with small hepatocellular carcinoma and cirrhosis regenerative nodules[J].Journal of Practical Medicine,2014,31(11):1000-1001.
[16]郑健辉,王秀河,张俊成,等.能谱CT碘基图对肝细胞癌化疗栓塞术后瘤体血供的分析[J].暨南大学学报(自然科学与医学版),2015,36(3):269-274.ZHENG J H,WANG X H,ZHANG J C,et al.The analysis of blood supply in hepatocellular carcinoma after transcatheter hepatic arterial chemoembolization(TACE)by the measurement of iodine-based image of spectral CT[J].Journal of Jinan University(Natural Science and Medicine Edition),2015,36(3):269-274.
[2]SEKI T,WAKABAYASHI M,NAKAGAWA T,et al.Percutaneous microwave coagulation therapy for patients with small hepatocellular carcinoma:comparison with percutaneous ethanol injection therapy[J].Cancer,2015,85(8):1694-1702.
[3]毛丽娟,王文平,丁红,等.肝细胞肝癌的动态三维超声造影成像质量的影响因素分析[J].中国临床医学,2016,23(3):273-277.MAO L J,WANG W P,DING H,et al.Imaging quality of dynamic three-dimensional contrast-enhanced ultrasonography in hepatocellular carcinoma:an analysis of influencing factors[J].Chinese Journal of Clinical Medicine,2016,23(3):273-277.
[4]陈挺松,罗明,李淑英,等.华蟾素注射液门静脉灌注联合TACE治疗肝癌合并门静脉癌栓的疗效及安全性评价[J].实用临床医药杂志,2016,20(21):31-33.CHEN T S,LUO M,LI S Y,et al.Clinical efficacy and safety of portal perfusion of cinobufacini injection combined with TACE in treatment of liver cancer patients complicated with portal vein tumor thrombus[J].Journal of Clinical Medicine in Practice,2016,20(21):31-33.
[5]陈国伟.多层螺旋CT在原发性肝癌诊断中的应用研究[J].现代医用影像学,2015,24(5):829-830.CHEN G W.Application of multi-slice spiral CT in the diagnosis of primary liver cancer[J].Modern Medical Imaging,2015,24(5):829-830.
[6]江发良.多层螺旋CT在肝癌肝动脉灌注栓塞后血供诊断中的应用价值分析[J].现代诊断与治疗,2015,13(24):5611-5612.JIANG F L.Application value of multi-slice spiral CT in the diagnosis of blood supply after transcatheter arterial chemoembolization of hepatocellular carcinoma[J].Modern Diagnosis and Treatment,2015,13(24):5611-5612.
[7]陈国硕,汤日杰,候毅斌,等.TACE联合重组人血管内皮抑制素治疗原发性肝癌后的DWI评估价值[J].临床放射学杂志,2015,34(1):115-119.CHEN G S,TANG R J,HOU Y B,et al.Clinical application of DWI in evaluating TACE combine with endostar for the treatment of primary hepatic carcinoma[J].Journal of Clinical Radiology,2015,34(1):115-119.
[8]刘浩,徐琴,孙晓凤.中晚期肝癌介入治疗患者的生存质量及预后影响因素分析[J].川北医学院学报,2016,31(5):693-695.LIU H,XU Q,SUN X F.Analysis of QOL and prognostic influencing factors of patients with middle and advanced hepatic cancer treated by interventional treatment[J].Journal of North Sichuan Medical College,2016,31(5):693-695.
[9]俞礽爱,刘佳,乐弈,等.外科手术联合TACE治疗晚期肝癌合并门静脉癌栓的疗效分析[J].中国普通外科杂志,2015,24(7):933-938.YU R A,LIU J,LE Y,et al.Surgical resection plus transcatheter arterial chemoembolization for advanced hepatocellular carcinoma with portal vein tumor thrombus:an analysis of therapeutic efficacy[J].Chinese Journal of General Surgery,2015,24(7):933-938.
[10]曾春.DWI联合CT增强扫描在评估TACE治疗肝癌患者的临床价值[J].中国CT和MRI杂志,2016,14(4):80-83.ZENG C.Clinacal value of DWI combined with CT enhanced scan in the evaluation of transcatheter arterial chemoembolization in the treatment of patients with liver cancer[J].Chinese Journal of CT and MRI,2016,14(4):80-83.
[11]王楚铭.多排螺旋CT肝血流灌注参数诊断原发性肝癌的意义探讨[J].实用肝脏病杂志,2016,19(2):223-224.WANG C M.Hepatic perfusion parameters by multiple spiral CT scan in patients with primary liver cancer[J].Journal of Practical Hepatology,2016,19(2):223-224.
[12]刘凌晓,王建华,王小林,等.经皮热消融同步肝动脉化疗栓塞(TACE)治疗肝癌的临床价值[J].复旦学报:医学版,2015,42(1):1-6.LIU L X,WANG J H,WANG X L,et al.The clinical value of simultaneous percutaneous thermal ablation and transarterial chemoembolization(TACE)for liver cancer[J].Fudan University Journal of Medical Sciences,2015,42(1):1-6.
[13]王雨,唐腾骞,张辉,等.CT及多层螺旋CT对索拉菲尼治疗原发性肝癌前后的评判对比研究[J].肿瘤药学,2016,6(6):451-455.WANG Y,TANG T Q,ZHANG H,et al.A study of CT in monitoring the effects of sorafenib on primary hepatic carcinoma[J].Anti-tumor Pharmacy,2016,6(6):451-455.
[14]马冬,罗娅红,郑文恒,等.256多层螺旋CT一站式扫描在原发性肝癌中的应用[J].肿瘤学杂志,2015,21(10):839-842.MA D,LUO Y H,ZHEN W H,et al.The application of 256 rows of one-stop CT scan in primary hepatic cancer[J].Journal of Chinese Oncology,2015,21(10):839-842.
[15]李保全,赵宏伟,白雪峰.肝硬化合并小肝癌与肝硬化再生结节多层螺旋CT灌注成像分析[J].实用医药杂志,2014,31(11):1000-1001.LI B Q,ZHAO H W,BAI X F.Multislice spiral CT perfusion imaging analysis of cirrhosis with small hepatocellular carcinoma and cirrhosis regenerative nodules[J].Journal of Practical Medicine,2014,31(11):1000-1001.
[16]郑健辉,王秀河,张俊成,等.能谱CT碘基图对肝细胞癌化疗栓塞术后瘤体血供的分析[J].暨南大学学报(自然科学与医学版),2015,36(3):269-274.ZHENG J H,WANG X H,ZHANG J C,et al.The analysis of blood supply in hepatocellular carcinoma after transcatheter hepatic arterial chemoembolization(TACE)by the measurement of iodine-based image of spectral CT[J].Journal of Jinan University(Natural Science and Medicine Edition),2015,36(3):269-274.