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背景与目的应用CT灌注成像评价原发性肝癌TACE治疗前后的血供改变。材料和方法原发性肝癌病例33例,分别于TACE术前1～7天及术后40天～57天行16排螺旋CT灌注成像扫描。结果33例病例肝癌组织的HAP值、HPP值及HPI均值均与瘤旁正常肝组织有明显差异,TLP值与瘤旁正常肝组织无明显差异。经导管动脉化疗栓塞术(TACE)后33例病例肿瘤残留区的HAP、HPI及TLP值均较治疗前减少,HPP无明显变化;肿瘤残留区时间-密度曲线形态均与治疗前相似;肿瘤组织内碘油完全沉积区及完全坏死区无血流灌注;瘤旁正常肝组织的时间-密度曲线及HAP、HPP、TLP、HPI值均较术前无明显变化。结论肝动脉化疗栓塞术对瘤旁正常肝组织的血流灌注无明显影响,是准确、安全的治疗方法;CT灌注成像可以初步推断TACE术后病灶区仍有肿瘤残留,为原发性肝癌新的介入治疗模式——TACE术联合消融治疗的建立提供理论依据。
BACKGROUND & AIM: To evaluate the changes of blood supply before and after TACE treatment of primary liver cancer by CT perfusion imaging. Materials and Methods Totally 33 cases of primary liver cancer were scanned with 16-slice spiral CT perfusion imaging at 1 ~ 7 days before TACE and 40 days ~ 57 days after TACE. Results The HAP value, HPP value and HPI mean value of hepatocellular carcinoma in 33 cases were significantly different from those of normal liver tissue. There was no significant difference between TLP and normal liver tissue. The HAP, HPI and TLP values of tumor residual area in 33 cases after transcatheter arterial chemoembolization (TACE) were lower than those before treatment, and there was no significant change in HPP. The time-density curve of tumor residual area was similar to that before treatment; There was no blood perfusion in complete deposition zone and completely necrotic zone of endoiodine oil. The time-density curve, HAP, HPP, TLP and HPI of normal liver adjacent tissue had no significant changes compared with those before operation. Conclusions Transcatheter arterial chemoembolization has no obvious effect on the perfusion of normal liver tissue adjacent to the tumor, which is an accurate and safe method of treatment. CT perfusion imaging can be preliminarily concluded that tumor remains in the lesion area after TACE, Interventional therapy model - TACE combined with ablation therapy to establish a theoretical basis.