新型双能CT融合技术对肝癌TACE术后的评估

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摘要目的：探讨改良双能量融合CT图像在肝癌TACE术后中的应用价值。方法：纳入TACE术后的26例肝癌患者，行肝脏CT常规平扫及增强三期扫描做术后评估，其中动脉期行双能扫描。使用两种后处理方法处理动脉期双能数据获得两组图像：A组图像由常规双能线性技术获得，B组图像采用新型双能量融合技术获得。以DSA为金标准，评估两种后处理方法对碘油沉积缺损区和（或）周边区强化病灶（活性区）的显示能力。结果：26例肝癌患者TACE术后复查共检出病灶60个，其中15个病灶DSA无染色，45个病灶DSA有明显肿瘤血管和染色。新型融合技术（B法）对病灶检出的敏感性为93.3%，高于常规融合技术（A法，71.1%）（χ2=8.1，P=0.004）；B法的特异性为93.3%，与A法（66.7%）无明显统计学差异（χ2=1.5，P=0.221）。且B法与DSA的一致性较优（K=0.83，P=0.000）。结论：肝癌TACE术后，新型动脉期双能融合图像技术比常规双能量融合技术能更好显示碘油沉积缺损区和（或）周边区的强化病灶。

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	张大福
	李振辉
	杨光军
	王关顺
	廖承德
	丁莹莹

关键词 ：肝肿瘤, 体层摄影术, X线计算机

Abstract：Objective: To evaluate the application value of a new modified dual energy image fusion in hepatocellular carcinoma after transcatheter arterial chemoembolization(TACE). Method: Twenty-six hepatocellular carcinoma(HCC) patients after post-TACE underwent normal and three phases dual-energy CT scanning(non-enhanced, arterial, portal, and delayed phases scanning) were enrolled. The arterial phase scans used the dual-energy mode. Two image sets were used to process the data: A, the weighted average image was automatically generated from a linear blending of the data. B, the new double energy fusion was obtained. DSA regarded as the gold standard, we evaluated the feasibility of two image sets, which discriminate contrast enhanced lesions from compact iodized oil accumulations, thereby helping to identify viable lesions around the HCC previously-treated by TACE. Result: DSA revealed 60 lesions in 26 patients, and 45 of them had clear tumor vessel and supply blood. The sensitivity of B(93.3%) was higher than that of A(71.1%)(χ2=8.1, P=0.004), while the specificity of B(93.3%) was insignificantly different with A(66.7%)(χ2=1.5, P=0.221). The B set has a better consistency of DSA(K=0.83, P=0.000). Conclusion: After HCCs with TACE, displaying of iodized oil accumulations and/or enhanced lesion in outside is much better in the new double energy fusion than that in conventional CT protocol.

Key words： Liver neoplasms Tomography, X-ray computed

收稿日期: 2015-12-16

PACS:	Ｒ735.7
	Ｒ814.42

通讯作者: 丁莹莹，昆明医科大学第三附属医院云南省肿瘤医院放射科，650118。E-mail：d_yying@hotmail.com

作者简介: 张大福（1983-），男，云南宣威人，主治医师。E-mail：249434782@qq.com

引用本文:

张大福，李振辉，杨光军，王关顺，廖承德，丁莹莹. 新型双能CT融合技术对肝癌TACE术后的评估[J]. 中国临床医学影像杂志, 2016, 27(8): 557-561.
ZHANG Da-fu, LI Zhen-hui, YANG Guang-jun, WANG Guan-shun, LIAO Cheng-de, DING Ying-ying. Evaluation of hepatocellular carcinoma after TACE by using new dual energy image fusion technique. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(8): 557-561.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2016/V27/I8/557

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