CT减影法评价肝细胞癌TACE后残余肿瘤活性的研究

发布时间：2018-05-01 20:04

本文选题：肝细胞癌 + TACE　；参考：《介入放射学杂志》2017年01期

【摘要】：目的应用增强CT减影法评价肝细胞癌TACE后是否存在残余的肿瘤活性。方法回顾性连续收集临床确诊肝细胞癌并接受TACE患者22例,所有患者在第1次介入治疗之后均接受肝脏多期增强CT检查,并于第2次介入检查时评价肿瘤是否存在残余活性。使用增强CT动脉期图像减去平扫图像获得减影后图像,测量碘油沉积病灶减影后CT值,与第2次介入血管造影做对照,统计学分析减影后的图像判断肿瘤残余活性的能力。结果 22例肝细胞癌经TACE治疗患者中,第1次介入后共有37个病灶内见碘油沉积。经评价有肿瘤活性的病灶有34个,无肿瘤活性的病灶有3个。有肿瘤活性组的病灶减影后CT值为(79±68)HU;无肿瘤活性组中减影后CT值为(1±1)HU,两组数据差异有统计学意义(P=0.007)。使用受试者工作特征(ROC)曲线分析,当病灶减影后CT值大于1 HU时,诊断肿瘤残余活性的灵敏度为97.06%,特异度为100%,ROC曲线下面积可达0.975。结论使用增强CT动脉期与平扫减影图像,可以准确且直观地判断肝细胞癌TACE后是否存在残余肿瘤活性病变。
[Abstract]:Objective to evaluate the residual tumor activity of hepatocellular carcinoma (HCC) after TACE by enhanced CT subtraction. Methods 22 patients with hepatocellular carcinoma diagnosed clinically and received TACE were collected retrospectively. All patients underwent multiphase enhanced CT after the first interventional therapy. The residual activity of the tumor was evaluated at the second interventional examination. Contrast enhanced CT arterial phase images were subtracted from plain scan images to obtain subtraction images. The CT values after subtraction of lipiodol depositional lesions were measured and compared with the second interventional angiography. The ability of the images after subtraction to judge the residual activity of tumor was analyzed statistically. Results in 22 patients with hepatocellular carcinoma treated with TACE, there were 37 lesions with lipiodol deposit after the first intervention. 34 lesions with tumor activity and 3 lesions with no tumor activity were evaluated. The CT value after subtraction was 79 卤68 HUU in the active tumor group and 1 卤1 卤1 HUD in the non-tumor active group. The difference between the two groups was statistically significant (P < 0. 007). When CT value after subtraction was greater than 1 Hu, the sensitivity of diagnosis of residual tumor activity was 97.06, the specificity was 100 and the area under ROC curve could reach 0.975. Conclusion contrast enhanced CT and subtraction images can accurately and intuitively judge whether there is residual tumor active lesion in hepatocellular carcinoma after TACE.
【作者单位】：北京大学肿瘤医院(北京市肿瘤防治研究所、恶性肿瘤发病机制及转化研究教育部重点实验室)医学影像科;北京大学肿瘤医院(北京市肿瘤防治研究所、恶性肿瘤发病机制及转化研究教育部重点实验室)介入科;
【基金】：国家自然科学基金(81471640)
【分类号】：R735.7;R730.44

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