彩色编码数字减影血管造影在定量分析化疗栓塞前后肝脏肿瘤灌注减少中的应用价值

发布时间：2018-01-30 11:31

  本文关键词： 肝肿瘤灌注 肝动脉 肝动脉化疗栓塞 彩色数字减影血管造影 灌注减少　出处：《介入放射学杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探究彩色编码数字减影血管造影(ccDSA)在TACE术中对肝肿瘤灌注的即刻变化进行定量评测。方法回顾性研究了35例TACE治疗肝细胞癌病例。TACE术前后用相同参数采集二维数字减影血管造影(2D-DSA)。图像序列均经二维ccDSA(2D-ccDSA)进行后处理。在ccDSA图像上测量感兴趣区域(ROI),得到时间密度曲线(time-contrast-intensity CI[t]),并获取肿瘤血供时间(TBST),曲线下面积(AUC)、最大强化值(CI-Peak)和最大上升斜率(MS)这些灌注参数来分析评估TACE前后顺行血流和肿瘤染色减少的程度。并对上述参数与主观血管造影栓塞终点(SACE)标准和临床结果之间的关系进行分析。结果 TACE前后灌注参数的比较有显著差异。AUC和CI-Peak在TACE术后大幅下降。TBST在术后较之术前有显著延迟。灌注减少30%~40%相当于SACEⅢ级,灌注减少60%~70%相当于SACEⅣ级。结论 2D-ccDSA可以客观地量化评估TACE术对肝肿瘤血流灌注的影响,为TACE术提供了定量评价动脉血流停滞程度和肿瘤染色减少的指标。
[Abstract]:Objective to explore the color coded digital subtraction angiography (CCDSA). Methods 35 cases of hepatocellular carcinoma treated with TACE were retrospectively studied before and after the operation. The same parameters were used to collect 2D subtraction blood. Tube angiography (. 2D-DSA.Image sequences were all processed by 2D ccDSA-2D-ccDSA. the region of interest (ROI) was measured on ccDSA images. The time-contrast-intensity CI of time-density curve is obtained. [T], and obtained the tumor blood supply time (TBSTT, area under the curve AUC). Maximum reinforcement value (CI-Peak) and maximum rise slope (MSM). These perfusion parameters were used to analyze and evaluate the degree of the decrease of anterograde blood flow and tumor staining before and after TACE. Analysis of the relationship between criteria and clinical outcomes. Results. There was significant difference in perfusion parameters before and after TACE. AUC and CI-Peak decreased significantly after TACE. TBST was significantly delayed after TACE. The perfusion was reduced by 30% and 40%. It is equivalent to SACE 鈪，

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