可降解淀粉微球经动脉化疗栓塞术（DSM-TACE）治疗肝细胞癌：应用新型灌注软件的超声造影（DCE-US）对治疗效果的评估。

Degradable starch microspheres transarterial chemoembolisation (DSM-TACE) of HCC: Dynamic Contrast-Enhanced Ultrasonography (DCE-US) based evaluation of therapeutic efficacy using a novel perfusion software.

机构信息

Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.

出版信息

Clin Hemorheol Microcirc. 2012;52(2-4):123-9. doi: 10.3233/CH-2012-1590.

DOI:10.3233/CH-2012-1590

PMID:22960293

Abstract

PURPOSE

To evaluate therapeutic efficacy of degradable starch microsphere (DSM)-TACE in hepatocellular carcinoma (HCC) using Dynamic Contrast-Enhanced Ultrasonography (DCE-US) based perfusion analysis.

MATERIALS AND METHODS

A total of 60 DCE-US examinations were performed in 15 selected patients who underwent DSM-TACE with EmboCept®S for the treatment of advanced HCC. DCE-US was performed via i.v. application of ultrasound contrast media before and 24 hours post embolization. In addition DCE-US was performed with i.a. contrast application via the angiographic catheter right before and after the embolization. Microcirculation of embolized HCC lesions was quantified using a dedicated perfusion software by two experienced radiologists in consensus.

RESULTS

Significant reduction of microvascularization (PE, WiAUC and WiR) was seen right after DSM-TACE and during 24 hour follow-up. Mean PE was 342.22 ± 97.80 prior to embolization, 59.28 ± 29.74 post embolization (p = 0.019) and 18.83 ± 7.03 during follow-up (p ≤ 0.01). Mean WiAUC was 1103.21 ± 432.05 prior to embolization 267.69 ± 151.80 post embolization (p = 0.023) and 105.10 ± 44.43 during 24 hour follow-up (p ≤ 0.01). The corresponding values for WiR were 224.91 ± 57.97 prior-, 38.14 ± 18.80 post embolization (p = 0.034) and 6.97 ± 2.68 during follow up (p ≤ 0.01).

CONCLUSION

In this study, therapeutic efficacy of DSM-TACE in HCC using DCE-US based perfusion analysis could be demonstrated.

摘要

目的

使用基于动态对比增强超声（DCE-US）的灌注分析评估可降解淀粉微球（DSM）-TACE 治疗肝细胞癌（HCC）的疗效。

材料与方法

对 15 例接受 DSM-TACE 联合 EmboCept®S 治疗晚期 HCC 的患者进行了总共 60 次 DCE-US 检查。在栓塞前和栓塞后 24 小时通过静脉内应用超声造影剂进行 DCE-US 检查。此外，在栓塞前和栓塞后通过血管造影导管经动脉内应用造影剂进行 DCE-US 检查。两名有经验的放射科医生使用专用灌注软件对栓塞 HCC 病变的微循环进行定量评估。

结果

在 DSM-TACE 后即刻和 24 小时随访期间，微血管化（PE、WiAUC 和 WiR）明显减少。栓塞前平均 PE 为 342.22±97.80，栓塞后为 59.28±29.74（p=0.019），随访期间为 18.83±7.03（p≤0.01）。栓塞前平均 WiAUC 为 1103.21±432.05，栓塞后为 267.69±151.80（p=0.023），24 小时随访时为 105.10±44.43（p≤0.01）。相应的 WiR 值为 224.91±57.97 前，38.14±18.80 栓塞后（p=0.034）和 6.97±2.68 随访期间（p≤0.01）。