【摘要】 目的通过多层螺旋CT灌注成像来研究肝转移瘤(HMs)在经导管化疗栓塞术(TACE)后的血流动力学特征及变化,并分析TACE术前肿瘤组织的灌注参数与碘化油(LPD)沉积是否存在相关性。方法对20例HMs患者在TACE术前2～4 d和术后30～40 d分别行CT灌注成像扫描,测量术前肿瘤组织及术后病灶非碘油沉积区(包括复发及残余肿瘤,坏死区除外)的CT灌注参数。结果 15例HMs患者在TACE术后病灶非碘油沉积区的HBF、HBV、HAP下降,有显著性差异;术后MTT、PS、HAF、PVP虽然也下降,但无显著差异。上述15例HMs非碘油沉积区的HBF、HBV、MTT、HAF及PVP与周围正常肝实质参数值相比,存在显著差异。另有5例HMs在TACE术后未见明显碘油沉积。根据上述差异并行相关性分析后得出HMs在TACE术后的碘油沉积与CT灌注参数HAF和HAP有关。结论 CT灌注成像可以有效评价TACE术后肝转移瘤的血流灌注改变,对指导肝转移瘤的介入治疗有着重要价值。更多还原

【Abstract】 Objective To study hepatic metastases and its hemodynamics characteristics and changes after TACE by using CT perfusion imaging,and to study whether perfusion parameter of tumor issue before TACE is associated with lipiodol deposition or not.Methods CT perfusion scanning was performed 2～4 days before TACE and 30-40 days after TACE in 20 cases with hepatic metastatic.The perfusion parameters of tumor issue and non lipiodol deposition area post-operation(including residual tumor and relapse,necrotic tissure were excluded) after TACE were measured.Results The HBF,HBV,HAP of 15 patients descended remarkably after TACE.Although MTT,PS,HAF,PVP descended after TACE too,there were no statistically significant differences.In the above 15 patients,HBF,HBV,MTT,HAF and PVP in non lipiodol deposition area are statistically significant compared with peripheral liver parenchyma.The other 5 hypovascular metastases had no lipiodol deposits after TACE.According to analysis of differences above and relativity,we could get the conclusion that the lipiodol deposits of hepatic metastases after TACE had connection with CT perfusion parameters HAF and HAP.Conclusions CT perfusion imaging which can effectively evaluate the blood perfusion changes of hepatic metastases after TACE objectively has a great bearing on guiding the interventional therapy to hepatic metastases.更多还原