Lin Yi-Yang, Lee Rheun-Chuan, Tseng Hsiuo-Shan, Liu Chien-An, Guo Wan-Yuo, Chang Cheng-Yen
Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, Taiwan.
School of Medicine, National Yang Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan.
Cardiovasc Intervent Radiol. 2015 Dec;38(6):1494-501. doi: 10.1007/s00270-015-1111-6. Epub 2015 May 12.
To quantitatively measure the hemodynamic change of hepatic artery before and after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) by quantitative color-coding analysis (QCA).
This prospective study registered 64 consecutive HCC patients who underwent segmental or subsegmental TACE with epirubicin and lipiodol at level 2 or 3 of the subjective angiographic chemoembolization endpoint. QCA was used to determine the maximal density time (T(max)) of selected intravascular region of interest (ROI). Relative T(max) (rT(max)) was defined as the T(max) at the selected ROI minus the time of contrast medium spurting from the catheter tip. The rT(max) of hepatic arteries was analyzed before and after embolization.
The pre- and post-treatment rT(max) of the landmarks at the treated segmental artery were 1.96 ± 0.48 and 3.14 ± 1.77 s, p < 0.001. According to the treated lobe, 30 patients were treated for the right lobe alone, and 8 patients were treated for the left lobe alone. The pre- and post-rT(max) of treated segmental artery were 2.06 ± 0.54, 3.34 ± 1.63 s, p < 0.001 and 1.89 ± 0.45, 2.68 ± 1.46 s, p = 0.12, respectively. The rT(max) of the proximal lobar hepatic arteries or proper hepatic artery had no significant change before and after TACE.
The QCA is feasible to quantify embolization endpoints by comparing the rT(max) in selected hepatic arteries before and after TACE. The rT(max) of treated segmental artery was significant prolonged after optimized procedures.
通过定量彩色编码分析（QCA）定量测量肝细胞癌（HCC）经动脉化疗栓塞术（TACE）前后肝动脉的血流动力学变化。
本前瞻性研究纳入了64例连续的HCC患者，这些患者在主观血管造影化疗栓塞终点的2级或3级接受了表阿霉素和碘油的节段性或亚节段性TACE。QCA用于确定选定血管内感兴趣区域（ROI）的最大密度时间（T(max)）。相对T(max)（rT(max)）定义为选定ROI处的T(max)减去造影剂从导管尖端喷出的时间。分析栓塞前后肝动脉的rT(max)。
治疗节段动脉处标志物的治疗前和治疗后rT(max)分别为1.96±0.48和3.14±1.77秒，p<0.001。根据治疗的肝叶，30例患者仅接受右叶治疗，8例患者仅接受左叶治疗。治疗节段动脉的治疗前和治疗后rT(max)分别为2.06±0.54、3.34±1.63秒，p<0.001和1.89±0.45、2.68±1.46秒，p = 0.12。TACE前后叶肝动脉近端或肝固有动脉的rT(max)无显著变化。
通过比较TACE前后选定肝动脉中的rT(max)，QCA可用于量化栓塞终点。优化程序后，治疗节段动脉的rT(max)显著延长。
