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目的:研究CT灌注成像在评价肝癌TACE术后血流动力学改变中的价值。方法:本组60例肝癌患者TACE术前行CT灌注成像扫描,其中43例接受肝癌TACE治疗后行CT灌注扫描。应用去卷积算法,计算肝血流量(BF)、血容量(BV)、平均通过时间(MTT)、肝动脉灌注指数(HAP)、毛细血管表面通透性(PS)等。根据各灌注参数值及其各参数伪彩功能图、BI图评价肝癌TACE术后血流动力学改变。结果:全部受试者均按要求完成检查。基线图像(BI)显示TACE术后肝癌区域碘油沉积形态完缺损型或环形35例,簇集型8例。BF、BV、MTT、HAF灌注图显示肝癌病灶内碘油沉积区为低灌注区,肝癌组织非碘油沉积区为对比背景肝组织为不同程度高灌注区。肝癌在TACE术后,BF、BV和HAP值较肝癌TACE术前减少,而MTT和PS值在肝癌TACE术前、术后无显著性差异。结论:肝脏CT灌注成像BI图、肝脏灌注参数(BF、BV和HAP)可有效的评价TACE术后肝癌组织的血流灌注改变,具有重要的临床应用价值。
Objective: To study the value of CT perfusion imaging in the evaluation of hemodynamic changes after TACE of liver cancer. Methods: Totally 60 patients with liver cancer underwent TACE before CT perfusion imaging, of which 43 patients underwent TACE of liver cancer after CT perfusion scan. Depletion algorithm was used to calculate the liver blood flow (BF), blood volume (BV), mean transit time (MTT), hepatic artery perfusion index (HAP), capillary surface permeability (PS) According to the value of each perfusion parameter and the pseudo-color function chart of each parameter, the hemodynamic changes of hepatocellular carcinoma after TACE were evaluated by BI chart. Results: All subjects completed the examination as required. Baseline images (BI) showed 35 cases of complete lipiodol deposition or ring shape in the liver cancer region after TACE, and 8 cases of clustering. The perfusion maps of BF, BV, MTT and HAF showed that the area of lipiodol deposition in liver cancer was low perfusion area, and the non-lipiodol deposition area in liver cancer tissue was contrast background. The values of BF, BV and HAP in HCC after TACE were lower than those before TACE in HCC, while the MTT and PS values were not significantly different before and after TACE in HCC. Conclusion: The hepatic CT perfusion imaging and liver perfusion parameters (BF, BV and HAP) can effectively evaluate the changes of perfusion in TACE postoperative hepatocarcinoma, which has important clinical value.