MSCTA及CT灌注成像对原发性肝癌TACE术后评估的临床价值

目的探讨MSCTA及CT灌注成像（CTPI）在原发性肝癌TACE术后评估中的临床价值。方法对36例接受TACE的原发性肝癌患者于术后行MSCTA及CTPI,分析MSCTA对TACE术后肿瘤血管及CTPI对术后肿瘤局部活性的显示情况。结果 36例患者腹腔动脉MSCTA均能清楚显示活性病灶肿瘤供血动脉,与DSA差异无统计学意义（P〉0.05）。肝动脉灌注（HAP）、门静脉灌注（PVP）和肝动脉指数（HPI）在非瘤肝组织的和TACE术后肿瘤局部活性灶或复发区比较,差异均有统计学意义（P均〈0.01）。结论 MSCTA能很好地显示原发性肝癌TACE术后肿瘤新生血管情况,CTPI能准确反映肝癌TACE术后肿瘤局部活性,两者相结合对显示肿瘤残存及复发、指导后续治疗有较高临床应用价值。

Clinical value of multi-slice spiral CT angiography and CT perfusion imaging in estimating primary hepatocellular carcinoma after TACE

Objective To discuss the clinical value of MSCTA and CT perfusion imaging(CTPI) in estimating primary hepatocellular carcinoma(PHC) after TACE.Methods MSCTA and CTPI were performed in 36 patients with PHC after TACE.The value of MSCTA in displaying appearances of tumor vascularity and CTPI in detecting the activity of residual PHC after TACE were assessed.Results In 36 patients,MSCTA of celiac artery clearly showed arterial tumor vessels.No statistical difference was found between MSCTA and DSA(P>0.05).After considering local activity area or recurrence area of tumor with non-tumor liver perfusion parameters and tissue perfusion parameters,the differences in both of the hepatic arterial perfusion(HAP),portal vein perfusion(PVP) and hepatic perfusion index(HPI) were statistically significant(all P<0.01).Conclusion MSCTA can well display neogenesis of tumor vascularity.CTPI can accurately response the activity of partial tumor lesions after TACE.Combination of them has higher clinical value in judging tumor recurrence and guiding subsequent treatment.