Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China.
J Vasc Interv Radiol. 2010 Dec;21(12):1841-6. doi: 10.1016/j.jvir.2010.08.015. Epub 2010 Oct 27.
To study the correlation of tumor perfusion with lipiodol deposition in hepatocellular carcinoma (HCC) after transarterial chemoembolization with multidetector computed tomography (MDCT) perfusion imaging.
MDCT perfusion imaging was performed in 24 patients with HCC 1 to 7 days before chemoembolization. The computed tomography (CT) perfusion parameters, such as hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP), total liver perfusion (TLP), and hepatic arterial perfusion index (HAPI), were calculated with the slope method. The follow-up CT scans (noncontrast) were performed 4 weeks after chemoembolization to analyze lipiodol deposition. The lipiodol deposition in the tumor was classified into three grades and compared with CT perfusion parameters before chemoembolization.
The HAP and TLP of tumors before chemoembolization were correlated with the grades of lipiodol deposition in tumors after chemoembolization (r = 0.768, P < .0001 and r = 0.616, P = .001, respectively). However, the HPP and HAPI of the tumors were not related to the grades of iodized oil deposition (r = 0.227, P = .286 and r = 0.111, P = .607, respectively). Higher HAP was correlated with better lipiodol deposition, and lower HAP was correlated with poorer lipiodol deposition.
MDCT perfusion imaging has the potential to help select more appropriate patients with HCC for chemoembolization.
利用多排螺旋 CT(MDCT)灌注成像研究肝癌(HCC)经肝动脉化疗栓塞(TACE)后肿瘤灌注与碘油沉积的相关性。
24 例 HCC 患者在 TACE 前 1-7 天行 MDCT 灌注成像。采用斜率法计算 CT 灌注参数,如肝动脉灌注(HAP)、肝门静脉灌注(HPP)、总肝灌注(TLP)和肝动脉灌注指数(HAPI)。TACE 后 4 周行增强 CT 扫描(非对比剂)以分析碘油沉积。将肿瘤内碘油沉积分为 3 个等级,并与 TACE 前 CT 灌注参数进行比较。
TACE 前肿瘤的 HAP 和 TLP 与 TACE 后肿瘤内碘油沉积等级呈正相关(r = 0.768,P <.0001 和 r = 0.616,P =.001)。然而,肿瘤的 HPP 和 HAPI 与碘油沉积等级无相关性(r = 0.227,P =.286 和 r = 0.111,P =.607)。较高的 HAP 与较好的碘油沉积相关,而较低的 HAP 与较差的碘油沉积相关。
MDCT 灌注成像有可能帮助选择更合适的 HCC 患者进行 TACE。