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目的探讨能谱CT物质定量分析与肝癌TACE术后碘油沉积情况的相关性及其临床价值。方法对28例原发性肝癌患者TACE术前进行能谱CT扫描,术后1个月CT复查。利用能谱分析软件(GSI)对术前能谱图像进行后处理,用混合能量和单能量图像对病灶进行观察,分别记录动脉期、静脉期肿瘤病灶碘基值及对比术后复查图像病灶碘油沉积区域和无碘油沉积区域术前碘基值、腹主动脉和门静脉碘基值。结果术后仅1例病灶碘油完全沉积。术后碘油沉积面积>50%病灶的术前动脉期标准化碘浓度(ANIC)较术后碘油沉积面积<50%的病灶高,分别为0.25±0.04、0.18±0.06(P<0.01),标准化碘浓度比率(ICratio)及静脉期标准化碘浓度(VNIC)差异无统计学意义。同一病灶碘油沉积区域动脉期标准化碘浓度(ANIC)较无碘油沉积区域高,分别为0.21±0.05、0.16±0.06(P<0.01)。结论利用能谱CT测得的动脉期标准化碘基值可以较好的预测TACE术后肝癌病灶碘油沉积情况,从而对评价肝癌预后及为TACE术筛选合适病例提供一定参考。
Objective To investigate the correlation between the quantitative analysis of spectral CT materials and the lipiodol deposition after TACE in hepatocellular carcinoma and its clinical value. Methods Twenty-eight patients with primary liver cancer underwent TACE before CT scan and one month after CT. Spectral analysis software (GSI) was used to preprocess the spectral images, and the lesions were observed with mixed energy and single energy images. The iodine value of tumor lesions in arterial phase and venous phase were recorded and compared with the postoperative Idiopathic Preoperative iodine value, abdominal aorta and portal vein iodine value in oil-deposited area and non-iodized oil deposition area. Results After operation, only 1 case of lipiodol completely deposited. The preoperative arterial iodine concentration (ANIC) of postoperative lipiodol deposition area> 50% was higher than that of postoperative lipiodol deposition area <50% (0.25 ± 0.04,0.18 ± 0.06, P <0.01) There was no significant difference between ICratio and VNIC. The arterial phase standardized iodine concentration (ANIC) in the same lesioned area was higher than that in the non-lipiod deposition area (0.21 ± 0.05,0.16 ± 0.06, P <0.01). Conclusion The standard iodine value of arterial phase measured by energy spectrum CT can predict the deposition of lipiodol in hepatocellular carcinoma after TACE, which will provide a reference for evaluating the prognosis of hepatocellular carcinoma and screening appropriate cases for TACE.