摘要
目的探讨GE-64排螺旋CT采用低剂量三期增强扫描评估肝细胞癌介入术后近期的疗效分析及临床指导价值。方法搜集我院2012年6月~2017年6月期间经临床、病理和螺旋CT综合诊断的肝细胞癌并行肿瘤介术后复查的病例。采用GE公司生产Lightspeed 64排螺旋CT进行三期低剂量增强扫描,对肝细胞癌介入治疗前、后,观察瘤体内碘油沉积率、瘤体内及周围血供动力学的变化。结果本组93例肿瘤较治疗前缩小者54例(58.1%),肿瘤病灶较前增大或边缘模糊不清12例(12.9%);病灶<5cm及介入治疗后碘油呈完全型充填,1~3个月复查CT无复发及病灶增大征象(P<0.05);病灶>5cm或并介入治疗后呈稀少型,1~3个月复查CT病灶明显进展(P>0.05);所有患者性别、年龄、病史等一般资料相较,差异无统计学意义(P>0.05);而肿瘤大小、碘油沉积类型相较,差别具有统计学意义(P<0.05)。在常规扫描参数下,DLP约(987±21.75)m Gy·cm,通过降低扫描参数后DLP约(385±9.28)m Gy·cm,辐射剂量明显降低(53±4)%。结论 64排螺旋CT低剂量三期增强扫描观察中晚期肝细胞癌介入栓塞治疗后瘤体形态学和血供动力学的变化,对评价介入治疗的效果及指导再次治疗时机具有重要意义。同时,确保CT图像的诊断质量前提下采用低剂量CT技术扫描,最大限度的减少患者及必需陪护人员的辐射剂量。在不影响诊断质量情况进行降低剂量CT扫描检查,减少有效剂量照射具有重要的临床意义,值得广大医疗中心大力推广。
Objective To evaluate the short-term efficacy and clinical value of GE-64 slice spiral CT in low dose three phase enhanced scan for hepatocellular carcinoma after interventional therapy. Methods Cases of hepatocellular carcinoma diagnosed by clinical pathology and spiral CT from June 2012 to June 2017 were collected.Lightspeed 64-slice spiral CT produced by GE Company was used to perform three-phase low-dose enhanced scanning. Before and after interventional therapy of hepatocellular carcinoma, the lipiodol deposition rate in the tumor and the changes of blood supply dynamics in and around the tumor were observed. Results In 93 cases of tumor,54（58.1%） were narrowed than those before treatment, and 12（12.9%） cases were enlarged or blurred.The lesion 5 cm and the complete filling of lipiodol after interventional therapy were followed up by CT for 1-3 months without recurrence and enlarged lesions（P〈0.05）.Lesion 〉5 cm or complicated by interventional therapy with rare type,review CT showed that of the lesion had significant progress after 1-3 months.There was no significant difference in sex,age and history of all patients（P〉0.05）.The tumor size and the type of lipiodol deposition were significantly different（P〈0.05）.Under the conventional scanning parameters,DLP was about（987±21.75）m Gy·cm.By reducing the scanning parameters,the radiation dose of DLP was reduced by about（385±9.28）m Gy·cm,and the radiation dose was significantly reduced by（53±4）%. Conclusion The changes of morphology and blood supply dynamics of middle and advanced hepatocellular carcinoma after interventional embolization were observed by low-dose threephase enhanced scanning with 64-slice spiral CT.It is significance to evaluate the effect of interventional therapy and to guide the opportunity of re-treatment.At the same time,to ensure the diagnostic quality of CT images,lowdose CT scanning was used to minimize the radiation dose of patients and necessary companions.It is of great clinical significance to make CT scan with reduced dose and reduce effective dose irradiation without affecting the quality of diagnosis,and it is worth popularizing in many medical centers.
作者
麦神忠
彭樱花
武义
杨有甜
刘伟波
MAI Shenzhong;PENG Yinghua;WU Yi;YANG Youtian;LIU Weibo(Image Center of the Yingde People＇s Hospital,Yingde 513000,China)
出处
《中国医药科学》
2018年第9期96-99,190,共5页
China Medicine And Pharmacy
基金
广东省清远市社会发展领域科技计划立项项目(2016B109)
