摘要
目的探讨CT全灌注成像在肝癌TACE介入术前肝储备功能评估中的价值。方法选取2016年1月至2018年12月原发性肝癌患者68例,均于TACE术前3 d进行CT全灌注成像,比较患者正常肝组织与肿瘤组织的HAP、PVP、TLP、HAPI及不同Child-Pugh分级患者的HAP、PVP、TLP、HAPI,分析灌注参数与Child-Pugh分级的相关性。结果正常肝组织的HAP与HAPI分别为(30.10±8.69)ml/(min·100 mL)、(22.01±5.03)%显著低于肿瘤组织(81.47±19.86)ml(min·100 mL)、(69.85±15.41)%,PVP与TLP分别为(0.52±18.27)、(148.10±31.11)ml(min·100 mL)显著高于肿瘤组织(40.01±9.88)、(123.10±26.49)ml(min·100 mL)(P<0.05)。Child-Pugh A级患者的HAPI显著低于B级患者,PVP与TLP显著高于B级患者(P<0.05)。Spearman相关性分析显示,HAP与Child-Pugh分级之间无明显相关性(r=0.119,P=0.367);HAPI与Child-Pugh分级呈明显正相关(r=0.442,P=0.002),PVP、TLP均与Child-Pugh分级呈显著负相关(r=-0.550、-0.489,P<0.01)。结论CT灌注成像可定量反映不同Child-Pugh分级患者的血流动力学改变,评估患者肝储备功能,可为TACE术前评估、手术效果预测提供参考。
Objective To investigate the value of computed tomographic(CT)perfusion imaging in the evaluation of liver reserve function before transcatheter arterial chemoembolization(TACE)intervention on liver cancer.Methods A total of 68 patients with primary liver cancer admitted to our hospital from January to February 2018 were enrolled.All patients underwent CT perfusion imaging 3 days before TACE.The hepatic arterial perfusion(HAP),portal venous perfusion(PVP),total liver perfusion(TLP)and hepatic arterial perfusion index(HAPI)were compared between normal liver tissue and tumor tissue,among patients with different Child-Pugh grades,and the correlation between perfusion parameters and Child-Pugh classification was analyzed.Results The HAP and HAPI of normal liver tissue were(30.10±8.69)ml/min/100 ml and(22.01±5.03)%,respectively,which were significantly lower than those of tumor tissue[(81.47±19.86)ml/min/100 ml,(69.85±15.41)%,P<0.05].The PVP and TLP were(80.52±18.27)ml/min/100 ml and(148.10±31.11)ml/min/100 ml,respectively,which were significantly higher than those of tumor tissue[(40.01±9.88)ml/min/100 ml,(123.10±26.49)ml/min/100 ml,P<0.05].The HAPI of Child-Pugh grade A patients was significantly lower than that of grade B patients,and the PVP and TLP of grade A patients were significantly higher than those of grade B patients(P<0.05).Spearman correlation analysis showed no significant correlation between the HAP and Child-Pugh classification(r=0.119,P=0.367).The HAPI was positively correlated with Child-Pugh classification(r=0.442,P=0.002).The PVP and TLP were negatively correlated with Child-Pugh classification(r=-0.550,P<0.001;r=-0.489,P<0.001).Conclusion CT perfusion imaging can quantitatively reflect the hemodynamic changes of patients with different Child-Pugh grades,and evaluate the liver reserve function of patients,which can provide reference for preoperative evaluation of TACE and prediction of surgical outcomes.
作者
杨怀龙
雷霆
YANG Huai-long;LEI Ting(Department of Imaging,Sichuan Mianyang 404 hospital,Mianyang,Sichuan 621000)
出处
《肝脏》
2020年第3期270-272,共3页
Chinese Hepatology
基金
2016年四川省卫生和计划生育委员会科研课题(16PJ371)。
关键词
CT全灌注成像
肝癌
经肝动脉化疗栓塞
肝储备功能
Computed tomographic perfusion imaging
Liver cancer
Transcatheter arterial chemoembolization
Liver reserve function
