CT增强扫描在评估原发性肝癌介入治疗近期疗效中的应用价值分析
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摘要
目的探讨CT增强扫描在评估原发性肝癌介入治疗近期疗效中的应用价值。方法选取我院2015年4月-2017年1月的收治的经导管肝动脉化疗栓塞术介入治疗的38例原发性肝癌患者,患者术后均进行了CT平扫及增强检查,以数字减影血管造影(DSA)检查结果为"金标准",分析CT增强扫描在评估原发性肝癌介入治疗近期疗效中的应用价值。结果DSA共检出59个病灶,CT平扫共检出病灶41个(69.49%),CT增强共检出病灶58个(98.30%),CT增强病灶检出率明显高于CT平扫(P<0.05),但与DSA检查结果相比无统计学意义(P>0.05)。CT增强对≥3cm、<3cm大小的病灶诊断灵敏度分别为94.44%、97.56%,明显高于CT平扫(P<0.05);CT增强对病灶供血动脉来源诊断灵敏度、特异度均明显高于CT平扫(P<0.05);CT增强对合并门静脉癌栓诊断灵敏度为70.83%,明显高于CT平扫70.83%(P<0.05);CT检查显示碘油沉积类型:完全型9个,缺损型22个,稀疏型11个,新发病灶17个。结论 CT增强扫描能有效评估原发性肝癌患者经导管肝动脉化疗栓塞术介入治疗后的近期效果。
Objective To explore the application value of CT enhanced scanning in evaluating the short-term efficacy of interventional therapy for primary liver cancer. Methods 38 patients with primary liver cancer who received transcatheter hepatic artery chemoembolization for interventional therapy in our hospital from April 2015 to January 2017 were selected. All the patients underwent CT plain scan and enhanced examination after surgery. The results of digital subtraction angiography(DSA) were taken as the "gold standard" to analyze the application value of CT enhanced scanning in evaluating the short-term efficacy of interventional therapy for primary liver cancer. Results A total of 59 lesions were detected by DSA, 41 lesions were detected by CT non-enhanced scanning(69.49%), 58 lesions were detected by CT enhanced scanning(98.30%), and the detection rate of enhanced lesions was significantly higher than that of CT plain scanning(P<0.05), but there was no statistical significance(P>0.05). The diagnostic sensitivity of lesions greater than or equal to 3cm and less than 3cm was 94.44% and 97.56%, respectively, significantly higher than that of CT plain scan(P<0.05). The diagnostic sensitivity and specificity of enhanced CT were significantly higher than that of non-enhanced CT(P<0.05). The diagnostic sensitivity of enhanced CT for complicated portal cancer emboli was 70.83%, which was significantly higher than that of non-enhanced CT(P<0.05). CT examination showed that there were 9 total, 22 defect, 11 sparse and 17 new lesions.Conclusion CT enhanced scanning can effectively evaluate the short-term efficacy of interventional therapy after transcatheter hepatic artery chemoembolization in patients with primary liver cancer.
Objective To explore the application value of CT enhanced scanning in evaluating the short-term efficacy of interventional therapy for primary liver cancer. Methods 38 patients with primary liver cancer who received transcatheter hepatic artery chemoembolization for interventional therapy in our hospital from April 2015 to January 2017 were selected. All the patients underwent CT plain scan and enhanced examination after surgery. The results of digital subtraction angiography(DSA) were taken as the "gold standard" to analyze the application value of CT enhanced scanning in evaluating the short-term efficacy of interventional therapy for primary liver cancer. Results A total of 59 lesions were detected by DSA, 41 lesions were detected by CT non-enhanced scanning(69.49%), 58 lesions were detected by CT enhanced scanning(98.30%), and the detection rate of enhanced lesions was significantly higher than that of CT plain scanning(P<0.05), but there was no statistical significance(P>0.05). The diagnostic sensitivity of lesions greater than or equal to 3cm and less than 3cm was 94.44% and 97.56%, respectively, significantly higher than that of CT plain scan(P<0.05). The diagnostic sensitivity and specificity of enhanced CT were significantly higher than that of non-enhanced CT(P<0.05). The diagnostic sensitivity of enhanced CT for complicated portal cancer emboli was 70.83%, which was significantly higher than that of non-enhanced CT(P<0.05). CT examination showed that there were 9 total, 22 defect, 11 sparse and 17 new lesions.Conclusion CT enhanced scanning can effectively evaluate the short-term efficacy of interventional therapy after transcatheter hepatic artery chemoembolization in patients with primary liver cancer.
引文
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[13]庞玉花,马晓明,王金环. CPS定量分析在确定原发性肝癌安全边界中的应用及与肿瘤血管生成的相关性研究[J].河北医药,201 7(24):3799-3801.
[14]袁月德,刘梅存.三维彩色多普勒超声与超声造影对鉴别诊断原发性肝癌及转移性肝癌的价值[J].中国医疗设备,2018, 32(6):201-202.
[15]石朋,王坤,沈俊春,等.CT检查在原发性肝癌患者经肝动脉化疗栓塞术后疗效评估中的应用价值分析[J].实用肝脏病杂志,2018,21(2):253-256.
[16]李万湖,董帅,胡旭东,等.多层螺旋CT血管造影对原发性肝癌动静脉瘘和肝外供血动脉评估价值[J].中华肿瘤防治杂志,2017,24(11):755-758.
[17]黄卫民,徐辉,汪继辉.CT增强扫描和DSA检测原发性肝癌TACE术后肿瘤残留及新发病灶[J].中国C T和MRI杂志,2016,14(9):77-79.
[18]Oikawa T.Cancer Stem Cells and Their Cellular Origins in Primary Liver and Biliary Tract Cancers[J].Hepatology,2016, 64(2):645.
[19]吴杨,施丽丽,房海燕,等.原发性肝癌的CT灌注参数特征及肝脏储备功能评估价值[J].中国现代普通外科进展,2018,20(4):136-137.
[20]Aliberti C,Carandina R,Sarti D,et al.Hepatic Arterial Infusion of Polyethylene Glycol Drug-eluting Beads for Primary and MetastaticLiver Cancer Therapy[J].Anticancer Research,2016,36(7):3515-3521.
[2]李振燕,陈勇良,杜瑞清,等.原发性肝癌超声造影与增强CT对照分析[J].河北医药,2 01 6, 44(2):2 1 2-214.
[3]蒋明,胡鸿涛.超声造影、增强CT扫描及MR I在评估肝癌介入治疗疗效中的应用比较[J].中国CT和MRI杂志,2017, 15(8):88-90.
[4]余炎,吕君,余祖江,等.四种影像学检查评价原发性肝癌患者介入治疗的疗效[J].实用肝脏病杂志,2017, 20(2):199-202.
[5]李振燕,陈勇良,杜瑞清,等.常规超声与超声造影在原发性肝癌微波消融术后随访中的应用分析[J].河北医药,2016,44(1):62-64.
[6]中国抗癌协会肝癌专业委员会.原发性肝癌规范化病理诊断指南(2015年版)[J].中华肝胆外科杂志,2015, 21(11):833-839.
[7]徐三荣,束鹏浩,张勇,等.NFAT2在原发性肝癌中的表达及对肝癌细胞增殖及凋亡的影响[J].江苏大学学报(医学版),2017,27(2):98-102.
[8]杨海南,何广明,吴辉,等.功能CT评估肝癌患者肝储备功能与介入治疗风险关系的价值[J].中国CT和MRI杂志,2016, 14(1 1):66-69.
[9]何燕莲,余岳芬,刘振华.超声造影时间-强度曲线评价射频消融治疗肝癌的应用价值[J].现代中西医结合杂志,2018, 26(24):169-170.
[1 0]石颖秋.超声造影评价原发性肝癌DSA引导下肝动脉化疗栓塞治疗的疗效[J].现代肿瘤医学,2017, 24(23):3788-3790.
[11]米波.超声造影在不同分化程度的原发性小肝癌诊断中的应用研究[J].中国医疗设备,2016,31(8):47-50.
[12]潘佳倩,童双梅,汤静.La以及La相关蛋白在肝癌细胞中的表达和意义[J].医学分子生物学杂志,2018, 15(1):8-12.
[13]庞玉花,马晓明,王金环. CPS定量分析在确定原发性肝癌安全边界中的应用及与肿瘤血管生成的相关性研究[J].河北医药,201 7(24):3799-3801.
[14]袁月德,刘梅存.三维彩色多普勒超声与超声造影对鉴别诊断原发性肝癌及转移性肝癌的价值[J].中国医疗设备,2018, 32(6):201-202.
[15]石朋,王坤,沈俊春,等.CT检查在原发性肝癌患者经肝动脉化疗栓塞术后疗效评估中的应用价值分析[J].实用肝脏病杂志,2018,21(2):253-256.
[16]李万湖,董帅,胡旭东,等.多层螺旋CT血管造影对原发性肝癌动静脉瘘和肝外供血动脉评估价值[J].中华肿瘤防治杂志,2017,24(11):755-758.
[17]黄卫民,徐辉,汪继辉.CT增强扫描和DSA检测原发性肝癌TACE术后肿瘤残留及新发病灶[J].中国C T和MRI杂志,2016,14(9):77-79.
[18]Oikawa T.Cancer Stem Cells and Their Cellular Origins in Primary Liver and Biliary Tract Cancers[J].Hepatology,2016, 64(2):645.
[19]吴杨,施丽丽,房海燕,等.原发性肝癌的CT灌注参数特征及肝脏储备功能评估价值[J].中国现代普通外科进展,2018,20(4):136-137.
[20]Aliberti C,Carandina R,Sarti D,et al.Hepatic Arterial Infusion of Polyethylene Glycol Drug-eluting Beads for Primary and MetastaticLiver Cancer Therapy[J].Anticancer Research,2016,36(7):3515-3521.