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

发布时间：2018-11-02 09:24

【摘要】：目的研究功能CT对肝癌患者肝储备功能与介入治疗风险关系的评估价值。方法选取2012年3月至2015年10月期间广州医科大学附属第四医院及广州医科大学附属第二医院的64例原发性肝癌患者,均保留完整的临床治疗及CT影像资料。入选患者均接受肝动脉化疗栓塞术(TACE)介入治疗,且在TACE术前均给予双期增强扫描并行CT肝硬化分级。TACE术后1个月通过检测血清总胆红素(TBIL)、血清白蛋白(ALB)等指标评价肝功能损害情况,回顾性观察TACE术后肝功能重度受损组(记为A组,23例)和肝功能轻度受损组(记为B组,41例)的CT影像数据资料,进一步比较不同CT肝硬化分级患者的2年生存率及吲哚氰绿潴留率(ICGR15)差异。结果 A、B两组TACE前CT扫描肝灌注参数数HAP、PVP、TLP、HBF均存在显著差异(P0.05);CT肝硬化分级:I级12例,II级28例,III级16例,IV级8例,预后分析显示CT肝硬化I-II级患者ICGR15(7.45±2.14)%、2年随访生存率72.5%(29/40)均优于III-IV级患者(16.22±3.16)%、45.8%(11/24),差异显著(P0.05)。结论功能CT扫描肝灌注参数、CT肝硬化分级能较好的评估肝储备功能和TACE风险,为肝储备功能及临床治疗提供重要评估依据。
[Abstract]:Objective to evaluate the relationship between hepatic reserve function and risk of interventional therapy in patients with hepatocellular carcinoma (HCC) by functional CT. Methods from March 2012 to October 2015, 64 patients with primary liver cancer were selected from the fourth affiliated Hospital of Guangzhou Medical University and the second affiliated Hospital of Guangzhou Medical University. The data of clinical treatment and CT imaging were all preserved. All the patients received (TACE) interventional therapy after transcatheter arterial chemoembolization (TACE), and were given double phase enhanced scanning before TACE and CT cirrhosis grading. The serum total bilirubin (TBIL), was detected 1 month after TACE. Serum albumin (ALB) was used to evaluate the liver function damage. The CT imaging data of severe liver function impairment group (group A, 23 cases) and mild liver function impairment group (group B, 41 cases) after TACE operation were observed retrospectively. The 2-year survival rate and indocyanine green retention rate (ICGR15) in patients with different CT liver cirrhosis grades were further compared. Results there was significant difference in the number of hepatic perfusion parameters (HAP,PVP,TLP,HBF) between the two groups before TACE (P0.05). CT cirrhosis grade: I 12 cases, II 28 cases, III 16 cases, IV 8 cases. The prognosis analysis showed that ICGR15 in I-II grade of CT cirrhosis was (7.45 卤2.14)%. The 2-year survival rate of 72.5% (29 / 40) was significantly higher than that of III-IV (16.22 卤3.16)% and 45.8% (11 / 24) (P0.05). Conclusion the hepatic perfusion parameters of functional CT scan and the grading of liver cirrhosis with CT can be used to evaluate liver reserve function and risk of TACE and provide important basis for evaluation of liver reserve function and clinical treatment.
【作者单位】：广州医科大学附属第四医院放射;广州医科大学附属第二医院放射科;
【分类号】：R445.3;;R735.7

【相似文献】