关键词: 原发性肝癌, 双源CT全肝灌注成像, 经肝动脉化疗栓塞术, 残余病灶, 疗效评估

Abstract: Objective The aim of this study was to investigate CT wholeliver perfusion image feature in patients with primary liver cancer (PLC) and evaluation of residual lesions after transcatheter arterial chemoembolization (TACE). Methods 94 patients with PLC were enrolled in our hospital between January 2021 and August 2023, and all underwent TACE therapy. All patients were examined by 128-slice dual-source CT machine before andone month after surgery, and blood volume (BV), blood flow (BF), hepatic artery perfusion volume (ALP), hepatic perfusion index (HPI), starting time (TTS) and portal vein perfusion volume (PVP) were recorded. Receiver operating characteristic curve (ROC) was applied toevaluate efficacy of CTperfusion parameters in evaluating residual lesions after TACE. Results Before TACE, CT scan revealed uniform hyperperfusion in 59 lesions, uneven hyperperfusion in 35 lesions and low perfusion on PVP image; one month after TACE, complete remission was found in 21 cases (22.3%), with low perfusion on ALP image, and lipiodol deposition or partial deposition in 73 cases, with high hyperperfusion on ALP image; one month after TACE, BV,BF, ALP and HPI in 21 complete remission lesions were (5.3±1.2)ml/100 ml, (42.7±7.6)ml/(100 ml·min^-1), (15.1±3.7)ml/(100 ml·min^-1) and (19.5±2.1)%, all significantly lower than [(11.2±1.9)ml/100ml, (84.4±10.4)ml/(100 ml·min^-1), (38.9±5.7)ml/(100 ml·min^-1) and (74.4±8.9)%, P<0.05], while TTS and PVP were (11.9±2.1)s and (45.7±4.5)ml/(100 ml·min^-1), both significantly greater than [(6.4±1.4)s and (12.2±2.1)ml/(100 ml·min^-1), P<0.05] before TACE; after TACE, ALP and HPI in residual lesions were (46.1±6.2)ml/(100 ml·min^-1)and (81.0±5.9)%, both much greater than [(38.5±5.3)ml/(100 ml·min^-1)and (75.3±5.6)%, P<0.05], while PVP was (7.7±2.5)ml/(100 ml·min^-1), much lower than [(11.8±2.1)ml/(100 ml·min^-1),P<0.05] before TACE; ROC analysis showed that the AUC was 0.940, with sensitivity of 87.7% and specificity of 89.4%, when combination of CT wholeliver perfusion image parameters in evaluating residual lesions after TACE. Conclusion Primary liver cancer lesions are highly perfused on dual-source CT whole liver perfusion imaging, and combined perfusion imaging parameters has a satisfactory evaluation of residual lesions after TACE.

Key words: Hepatoma, Dual-source CT whole liver perfusion imaging, Transhepatic arterial chemoembolization, Residual lesions, Remission