兰州大学机构库 >第一临床医学院
双源CT全肝灌注成像对原发性肝细胞肝癌TACE术后疗效的评估
Alternative TitleDual-source CT hepatic perfusion in evaluating the therapeutic effect of TACE for HCC
朱炳印
Subtype硕士
Thesis Advisor郭顺林
2016-05-24
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
KeywordCT灌注成像 原发性肝细胞肝癌 经动脉导管化疗栓塞
Abstract目的:利用双源CT灌注成像(CTPI)评价肝癌(HCC)经动脉导管化疗栓塞术(TACE)治疗前后的血流动力学变化,对疗效进行评估。 方法:23例中晚期HCC患者分别于术前及术后行双源CT全肝灌注扫描并产生伪彩图,分别测量病灶灌注参数值,评估TACE术后疗效。 结果:23例HCC术前灌注参数值分别为:BF 46.10±18.40 (mL/100mL/min);BV 12.50±4.32(mL/100mL);TTS 6.06±1.10(S);TTP 21.04±3.55(S);ALP 39.30±18.96 (mL/100mL/min);PVP 12.12±7.78(mL/100mL/min);HPI 78.04±15.74(%);5例术后完全被栓塞,灌注值为:BF 21.31±6.12(mL/100mL/min);BV5.10±1.55(mL/100mL);TTS 11.53±1.83(S)TTP22.71±4.47(S);ALP 14.27±4.09(mL/100mL/min);PVP 48.46±3.74(mL/100mL/min);HPI 14.82±3.20(%);18例术后部分被栓塞,其中栓塞区灌注值为:BF 32.77±14.53(mL/100mL/min);BV 9.24±6.69(mL/100mL);TTS 8.41±1.45(S);TTP 22.44±4.08(S);ALP 14.07±3.93(mL/100mL/min);PVP 83.28±14.80 (mL/100mL/min);HPI 31.58±12.34(%);残余区为:BF 46.32±13.08 (mL/100mL/min);BV 13.45±8.47(mL/100mL);TTS 5.13±1.31(S);TTP 22.10±3.32(S);ALP 46.22±12.98(mL/100mL/min);PVP 2.38±0.26(mL/100mL/min);HPI 95.16±17.58(%)。对完全栓塞的病灶,对比术前原发病灶,BV、ALP、HPI明显降低,TTS、PVP明显升高(P<0.05);对比栓塞不完全病灶的碘油沉积区与原发病灶,TTS、PVP明显增加,ALP、HPI明显减小(P<0.05);对比残余病灶区与术前原发性病灶,HPI明显增加(P<0.05),ALP轻度增加,PVP值明显减小(P=0.021);对比栓塞不完全病灶的碘油沉积区与残余病灶区,TTS、PVP值明显减低(P<0.05),ALP、HPI明显增加(P=0.00)。 结论:CTPI可用于HCC经TACE术治疗疗效的评估。
Other AbstractObjection: Use perfusion parameters of dual-source CT to evaluate the effections of TACE that treats the HCC. Method :23 cases of the advanced HCC which had been confirmed by liver pathology ,erology and imaging without any treatment,that consists with Barcelona(BCLC)criteria for diagnosis of HCC,with the percontrast、postcontrast triple-phase of dual-source CT low dose scaning and the whole liver perfusion scaning performed 1-2 days before operation and a month after postoperation.Intravenous bolus injection of 50mL nonionic iodinated contrast agent(iopamidol 370mg/mL)at a 5mL/s ,then additional saline 50mLat a 5mL/s,to get 25 dynamic scans;The spcial perfusion softwarewas used to produce perfusion pseudo-color imaging,lastly,the following quantitative data of BF,BV,TTS,TTP,ALP,PVP,HPI were used to assess the effect of preoperative and postoperative treatment with TACE. Result:The perfusion parameters before operation of 23 cases of HCC are respectively that BF46.10±18.40(mL/100mL/min),BV12.50±4.32(mL/100mL),TTS6.06±1.10(S),TTP21.04±3.55(S),ALP 39.30±18.96 (mL/100mL/min),PVP 12.12±7.78(mL/100mL/min),HPI 78.04±15.74(%).The perfusion parameters after operation of 5 cases HCC which are completely embolized by iodine oil are respectively that BF21.31±6.12(mL/100mL/min),BV5.10±1.55(mL/100mL),TTS11.53±1.8 3(S),TTP22.71±4.47(S),ALP14.27±4.09(mL/100mL/min),PVP48.46±3.74(mL/100mL/min),HPI 14.82±3.20(%). 18 cases HCC which are partially embolized by iodine oil after operation and the perfusion parameters embolized areas are respectively that BF32.77±14.53 (mL/100mL/min),BV 9.24±6.69(mL/100mL),TTS8.41±1.45(S),TTP22.44±4.08(S),ALP14.07±3.93(mL/100mL/min),PVP 83.28±14.80 (mL/100mL/min),HPI 31.58±12.34(%). The perfusion parameters of residual lesion areas of 18 cases HCC which are partially embolized by iodine oil are respectively that BF 46.32±13.08(mL/100mL/min),BV13.45±8.47(mL/100mL),TTS5.13±1.31(S),TTP22.10±3.32(S), ALP46.22±12.98(mL/100mL/min),PVP2.38±0.26(mL/100mL/min),HPI95.16±17.58(%). For the lesions which are completely embolized by iodine oil, BV,ALP and HPI of the focus of iodine oil completely embolism are lower than preoperation,TTS and PVP are higher,the difference has statistical significance(P<0.05);TTS and PVP of the focus of iodine oil incompletely embolismare higher than preoperation,ALP and HPI are lower,the difference has statistical significance(P<0.05); In the residual lesion area, compared with preop...
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/201193
Collection第一临床医学院
Recommended Citation
GB/T 7714
朱炳印. 双源CT全肝灌注成像对原发性肝细胞肝癌TACE术后疗效的评估[D]. 兰州. 兰州大学,2016.
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