320排容积CT一站式扫描对肝癌患者TACE预后评估指导价值

目的分析320排容积CT一站式扫描对肝癌患者经肝动脉插管化疗栓塞(TACE)治疗预后评定的价值。方法收集经血清甲胎球蛋白(AFP)、超声、CT或穿刺病理学确诊的60例肝癌患者,随机分为2组,术前行CT平扫及320排CT一站式扫描,以DSA作为金标准,比较CT诊断的准确性,一周内行TACE,术后复查CT,疗效不满意者,继续作TACE、射频消融(RFA)治疗,随访2年,统计TACE、RFA次数及远期生存率,总结320排容积CT对肝癌TACE预后评估的指导价值。结果 TACE前:患者肝癌组织HAP、HAPI高于非癌组织,PVP低于非癌组织(P0.05);TACE后:患者HAP、PVP上升,HAPI下降,与非癌组织对比,HAP、HAPI上升,PVP下降(P0.05);A组对4级、≥5级肝动脉血管显示率均低于B组与DSA,B组对≥5级肝动脉显示率低于DSA(P0.05);A组DLP、ED均低于B组(P0.05);A组再次TACE、RFA治疗次数均低于B组,生存率高于B组(P0.05)。结论肝癌TACE手术前后采用320排容积CT扫描,可分析患者灌注参数变化,动态评估疗效,指导下一步治疗,减少重复治疗次数。

Guiding Significance of 320 Slice Volume CT One-stop Scan in Evaluating the Prognosis of Patients with Liver Cancer after TACE

Objective To analyze the value of 320 slice volume CT one-stop scan in evaluating the prognosis of patients with liver cancer after transhepatic arterial chemotherapy and embolization (TACE).Methods 60 cases of patients with liver cancer confirmed by serum alpha fetoprotein (AFP), ultrasound and CT or puncture pathology were selected and were randomized into 2 groups. Before operation, CT plain scan and 320 slice CT one-stop scan were performed. With DSA as the golden standard, the accuracy of CT diagnosis was compared. In one week, TACE was performed and after operation, CT was performed. For patients with unsatisfying curative effect, they were treated with TACE and radiofrequency ablation (RFA). With 2 years of follow-up, the times of TACE and RFA and long-term survival rate were statistically analyzed. The guiding value of 320 slice volume CT one-stop scan in evaluating prognosis of patients with liver cancer after TACE was summarized.Results Before TACE, HAP and HAPI in liver cancerous tissues were higher than those in non-cancerous tissues while PVP was lower than that in non-cancerous tissues (P<0.05). After TACE, HAP and PVP increased while HAPI decreased. Compared with those in non-cancerous tissues, HAP and HAPI increased and PVP decreased (P<0.05). The display rates for grade 4 and grade ≥5 in group A were lower than those in group B and DSA. The display rate for grade ≥5 in group B was lower than that of DSA (P<0.05). DLP and ED in group A were lower than those in group B (P<0.05); The times of TACE and RFA again in group A was lower than that in B while the survival rate was higher than that in group B (P<0.05). Conclusions To adopt 320 slice volume CT scan before and after TACE can analyze the changes of perfusion parameters, dynamically evaluate curative effect, guide followed treatment, reduce the times of repeated treatment.