关键词: 肝细胞癌, CT灌注成像, 经导管动脉化疗栓塞术, 血管造影

Abstract: Objective To discuss the value of CT perfusion imaging(CTPI)in determining the effet of primary hepatic carcinoma(PHC)after intervention treatment.Methods 33 patients with hepatocellular carcinoma who agreed to accept transcatheter arterial chemoembolization(TACE)were involved in this study.Lesions were solitary.CTPI,enhanced CT and digital subtraction angiography(DSA)were performed one week before and one month after treatment.Taking DSA as the “gold standard”,the acquired blood perfusion colour-picture and the perfusion parameters were analyzed and compared to access the value of CTPI in determining the effect of PHC after TACE.Results Compared with preoperative tumor tissue,the values of the hepatic arterial perfusion(HAP),the hepatic perfusion index(HPI)and the total hepatic blood flow(THBF)of the postoperative one were decreased significantly(P＜0.01).The portal vein perfusion(PVP)showed no significant change(P＞0.05),and there was no blood supply in the lipiodol deposition or tumor necrosis area,the time density curve(TDC)of which showed a horizontal line,and compared with preoperative surrounding normal liver tissue.The CTPI value of the postoperative one had no significant change(P＞0.05).CTPI diagnosis accuracy was 93.94%;sensitivity was 100%,and specificity was 77.78%.CTPI on the detection of residual or recurrent hepatocellular carcinoma had a good agreement with DSA(kappa = 0.836,P=0.000).Conclusion CTPI can well reflect the blood supply of the local lesion and the surrounding normal hepatic tissue after TACE.It can partly replace DSA to evaluate the effect of PHC after TACE.

Key words: Primary hepatic carcinoma, CT perfusion imaging, Transcatheter arterial chemoembolization, Digital subtraction angiography