64排螺旋CT成像在肝癌患者介入治疗与治疗指导的应用价值研究

目的:探讨64排螺旋CT成像在肝癌患者介入治疗前检查中的应用价值及其影像对患者疾病治疗的指导价值。方法:选取医院收治的100例肝癌患者,患者于介入治疗前行64排螺旋CT扫描,对肝脏肿瘤肝内外供血动脉三维重建表现进行分析,并对比血管造影结果。同时计算患者肝血流量(BF)、血容量(BV)、平均通过时间(MTT)、毛细血管通透性(CP)和肝动脉灌注指数(HAPI),以此评价肝癌介入治疗前后的血流动力学状态。结果:经容积再现技术(VRT)重建均能清晰显示肿瘤肝内外供血动脉气源、走行且和血管造影一致,共发现52条供血动脉,57例患者肿瘤存在肝外供血。肝癌介入治疗后BF、BV、PS和HAF值显著高于治疗前(t=26.891,t=6.73,t=8.241,t=12.108;P<0.05),而MTT和肿瘤直径对比差异无统计学意义;介入治疗后BF、HAF值明显高于正常肝组织且BV、MTT和PS值低于正常肝组织(t=8.065,t=22.645,t=6.414,t=16.818,t=22.138;P<0.05)。结论:64排螺旋CT成像对于早期制定介入治疗方案有着重要意义,且在介入治疗后评估和后续治疗同样具有重要作用。

Studies on the application value of 64-slice spiral CT imaging in the interventional therapy of patients with HCC and the guidance value of these images for the treatment of disease

Objective:To investigate the application value of 64-slice spiral computed tomography(64-slice spiral CT)imaging in the examination of patients with hepatocellular carcinoma(HCC)before they received interventional therapy and the guidance value of these images in the treatment of patients'diseases.Methods:100 patients with HCC admitted in hospital were selected.64-slice spiral CT scanning was performed on patients before they received interventional therapy.The performances of three-dimensional reconstruction of intrahepatic and extrahepatic blood supply arteries of hepatocellular carcinoma were analyzed and the angiographic results were further compared.Meanwhile,blood flow(BF),blood volume(BV),mean transit time(MTT),capillary permeability(CP)and hepatic artery perfusion index(HAPI)of the liver of patients were calculated so as to evaluate the hemodynamic status of patients with HCC between before and after interventional therapy.Results:VRT reconstruction could clearly show the source and course of the blood supply arteries inside and outside the liver with cancer,and they were consistent with the results of angiography.A total of 52 blood supply arteries were found.And the cancers of 57 patients existed extrahepatic blood supply.The values of BF,BV,PS and HAF of patients after interventional therapy were significantly higher than those before interventional therapy(t=26.891,t=6.736,t=8.241,t=12.108,P<0.05).But there was no significant difference of MTT and tumor diameter between before and after interventional therapy.After interventional therapy,the values of BF and HAF of liver with cancer were significantly higher than those of normal liver tissue,and the values of BV,MTT and PS of liver with cancer were significantly lower than those of normal liver tissue(t=8.065,t=22.645,t=6.414,t=16.818,t=22.138,P<0.05).Conclusion:64-slice spiral CT imaging has important significance on the early formulation of interventional therapy scheme,and it also has important significance in the assessment and the follow-up therapy post interventional therapy.