SMI、CDFI和增强CT检查TACE术治疗的原发性肝癌患者癌组织血供显像效果比较*

doi:10.3969/j.issn.1672-5069.2020.01.025

实用肝脏病杂志 ›› 2020, Vol. 23 ›› Issue (1): 90-93.doi: 10.3969/j.issn.1672-5069.2020.01.025

SMI、CDFI和增强CT检查TACE术治疗的原发性肝癌患者癌组织血供显像效果比较^*

陈亮, 段海峰, 余红星

723000 陕西省汉中市中心医院放射科(陈亮,余红星); 陕西中医药大学附属医院放射科(段海峰)

收稿日期:2019-08-20 出版日期:2020-01-10 发布日期:2020-01-14
通讯作者: 余红星,E-mail:1374076663@qq.com
作者简介:陈亮,男,38岁,大学本科,主治医师
基金资助:
陕西省自然科学基金资助项目(编号：2018JM2055)

Detection of tumor foci blood supply by SMI, CDFI and enhanced CT in patients with primary liver cancer after TACE

Chen Liang, Duan Haifeng, Yu Hongxing

Department of Radiology,Central Hospital,Hanzhong 723000,Shaanxi Province,China

Received:2019-08-20 Online:2020-01-10 Published:2020-01-14

摘要/Abstract

摘要： 目的研究超微血管成像(SMI)、彩色多普勒血流成像(CDFI)和增强电子计算机断层扫描(CT)检测经肝动脉灌注化疗栓塞(TACE)术治疗的原发性肝癌(PLC)患者肿瘤血供显像的效果。方法 2016年4月～2019年4月我院收治的135例PLC患者,所有患者均接受TACE术治疗,于术后30 d接受SMI、CDFI和增强CT检查。结果 SMI和CDFI病灶血供检出率分别为54.2%和25.0%,均显著低于增强CT检测的84.5%(P＜0.05);针对直径＜2.0 cm的病灶,SMI和CDFI血供检出率分别为28.1%和0.0%,显著低于增强CT检测的73.7%(P＜0.05);针对直径≥2.0 cm的病灶,SMI和CDFI血供检出率分别为67.6%和37.8%,也显著低于增强CT检测的90.1%(P＜0.05)。结论在TACE术后,使用CT检查病灶血供最具有价值,其他检查可能简便,起辅助作用。

关键词: 原发性肝癌, 经肝动脉灌注化疗栓塞术, 增强电子计算机断层扫描, 彩色多普勒血流成像, 超微血管成像, 肿瘤血供

Abstract: Objective The aim of this study was to investigate the efficacy ofultramicro-angiography (SMI), color Doppler flow imaging (CDFI) and enhanced computed tomography (CT) in detecting tumor blood supply in patients with primary liver cancer (PLC) after transcatheter arterial chemoembolization (TACE). Methods 135 patients with PLC were admitted to our hospital between April 2016 and April 2019, and all patients underwent TACE and received SMI,CDFI and enhanced CT scan 30 days after operation. Results The detection rates of tumor blood supply by SMI and CDFI were 54.2% and 25.0%, respectively, both significantly lower than 84.5% by enhanced CT (P < 0.05); for lesions with diameter < 2.0 cm, the tumor blood supply detection rate by SMI and CDFI were28.1% and 0.0%, respectively, both significantly lower than 73.7% by enhanced CT (P< 0.05), and for lesions with diameter ≥2.0 cm, the detection rate of tumor blood supply by SMI and CDFI were 67.6% and 37.8%, respectively, both significantly lower than 90.1% by enhanced CT(P＜0.05). Conclusion The application of enhanced CT scan in evaluating tumor blood supply after TACE in patients with PLC might be useful in clinical practice, and SMI and CDFI are simple, convenient and economical.

Key words: Hepatoma, Transcatheter arterial chemoembolization, Computed tomography, Color doppler flow imaging, Superb micro-vascular imaging, Blood supply

陈亮, 段海峰, 余红星. SMI、CDFI和增强CT检查TACE术治疗的原发性肝癌患者癌组织血供显像效果比较^*[J]. 实用肝脏病杂志, 2020, 23(1): 90-93.

Chen Liang, Duan Haifeng, Yu Hongxing. Detection of tumor foci blood supply by SMI, CDFI and enhanced CT in patients with primary liver cancer after TACE[J]. Journal of Practical Hepatology, 2020, 23(1): 90-93.

参考文献

[1] Zhang Y, Ren JS, Shi JF, et al. International trends in primary liver cancer incidence from 1973 to 2007. BMC Cancer, 2015, 15(1):94-104.
[2] 杨海青, 孙伟娜. TACE治疗PLC患者血清肿瘤标志物水平变化. 实用肝脏病杂志, 2018, 21(1):123-124.
[3] Zhang DW, Xu AX. Application of dual-source CT perfusion imaging and MRI for the diagnosis of primary liver cancer. Oncol Lett, 2017, 14(5):5753-5758.
[4] Cong WM, Wu MC. New insights into molecular diagnostic pathology of primary liver cancer: Advances and challenges. Cancer Lett, 2015, 368(1):14-19.
[5] Gabriel M, Tomczak J, Snochziókiewicz M, et al. Superb micro-vascular imaging (SMI): a Doppler ultrasound technique with potential to identify, classify, and follow up endoleaks in patients after endovascular aneurysm repair (EVAR). Abdom Radiol, 2018, 43(12):3479-3486.
[6] 中华人民共和国卫生部. 原发性肝癌诊疗规范(2011年版). 中华肝脏病杂志, 2012, 20(6):929-946.
[7] Karavias D, Kourea H, Sotiriadi A, et al. Gangrenous cholecystitis related to transcatheter arterial chemoembolization (TACE) treatment for hepatocellular carcinoma.J Gastrointest Surg, 2015, 19(11):2093-2095.
[8] Huang W, You L, Yang S, et al. Metronomic S-1 chemotherapy plus transcatheter arterial chemoembolization (TACE): a promising treatment of hepatocellular carcinoma refractory to TACE. J Buon, 2016, 21(4):909-916.
[9] Ha TY, Hwang S, Lee YJ, et al. Absence of benefit of transcatheter arterial chemoembolization (TACE) in patients with resectable solitary hepatocellular carcinoma.World J Surg, 2015, 40(5):1200-1210.
[10] Ai N, Liu W, Li ZG, et al. High expression of GP73 in primary hepatocellular carcinoma and its function in the assessment of transcatheter arterial chemoembolization.Oncol Lett, 2017, 14(4):3953-3958.
[11] Maki S, Konno T, Maeda H. Image enhancement in computerized tomography for sensitive diagnosis of liver cancer and semiquantitation of tumor selective drug targeting with oily contrast medium. Cancer, 2015, 56(4):751-757.
[12] Yang K, Cheng YS, Yang JJ, et al. Primary hepatic neuroendocrine tumors: multi-modal imaging features with pathological correlations.Cancer Imaging, 2017, 17(1):20-26.
[13] Dong Y, Zhu Z, Wang WP, et al. Ultrasound features of hepatocellular adenoma and the additional value of contrast-enhanced ultrasound. Hepatobiliary Pancreat Dis Int, 2016, 15(1):48-54.
[14] Park AY, Seo BK, Cha SH, et al. An innovative ultrasoundtechnique for evaluation of tumor vascularity in breast cancers: superb micro-vascular imaging. J Breast Cancer, 2016, 19(2):210-213.
[15] 刘水清, 马一博, 韩宗宏, 等. 超微细血流成像技术评价肝癌介入治疗疗效的价值. 中华肝脏病杂志, 2017, 25(7):512-516.
[16] Kong SH, Yue XW, Kong S, et al. Application of contrast-enhanced ultrasound and enhanced CT in diagnosis of liver cancer and evaluation of radiofrequency ablation.Oncol Lett, 2018, 16(2):2434-2438.
[17] Durmaz MS, Sivri M. Comparison of superb micro-vascular imaging (SMI) and conventional Doppler imaging techniques for evaluating testicular blood flow.J Med Ultrason, 2018, 45(3):443-452.
[18] 杨志军, 赵丽娟. 超声超微细彩色血管成像技术评价经肝动脉化疗栓塞治疗的原发性肝癌患者肿瘤血供效能初步应用研究. 实用肝脏病杂志, 2018, 21(4):509-512.
[19] Lee DH, Lee JY, Han JK. Superb microvascular imaging technology for ultrasound examinations: Initial experiences for hepatic tumors. Eur J Radiol, 2016, 85(11):2090-2095.
[20] Liao M, Zhu Z, Wang H, et al. Adjuvant transarterial chemoembolization for patients after curative resection of hepatocellular carcinoma: a meta-analysis. Scand J Gastroenterol, 2017, 52(6):624-634.

SMI、CDFI和增强CT检查TACE术治疗的原发性肝癌患者癌组织血供显像效果比较^*

Detection of tumor foci blood supply by SMI, CDFI and enhanced CT in patients with primary liver cancer after TACE

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