Tian Hui, Wang Qi
Abdominal Ultrasound Department, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China.
Abdominal Ultrasound Department, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China.
Eur J Cancer. 2016 Nov;68:82-89. doi: 10.1016/j.ejca.2016.08.016. Epub 2016 Oct 10.
To conduct a quantitative analysis of microcirculation blood perfusion in patients with hepatocellular carcinoma (HCC) before and after transcatheter arterial chemoembolisation (TACE) using contrast-enhanced ultrasound (CEUS). From 2013 June to 2105 October, a total of 106 HCC patients undergoing TACE were recruited. CEUS was performed before and after TACE to determine time-intensity curve (TIC) and perfusion quantitative parameters of the HCC lesions and surrounding liver parenchyma. Quantitative perfusion parameters were obtained using the region of interest method. The microcirculation blood perfusion was measured with a blood analysis system and microcirculation microscope. Tumour microvessel density (MVD) was detected by CD34 immunohistochemistry. Compared with surrounding liver parenchyma, the HCC lesions had earlier arrive time (AT), time to initial peak (TTP) and acceleration time, and faster slope of rise time (a3), but no differences were observed in mean transit time (MTT), slope of decrease to half of peak (a2), peak intensity (PI), increased signal intensity (ISI), area under the curve (AUC) and blood flow (BF). There were significant differences in PI, a3, ISI, AUC and BF in HCC lesions between before and after TACE. The high blood viscosity, low blood viscosity, plasma viscosity and integral viscosity in HCC lesions increased after TACE, but the velocity of nailfold microcirculation decreased after TACE. The MVD of well-differentiated HCC lesions was higher than that of poor-differentiated HCC lesions under a light microscope at 50× magnification. However, no significant differences were found in MVD between well-differentiated and poor-differentiated HCC lesions under a light microscope at 100× and 200× magnifications. The PI, ISI, AUC and BF of poor-differentiated HCC lesions were significant lower than those of well-differentiated HCC lesions, but there were no differences in AT, TTP, ACU, MTT, a2 and a3. In conclusion, these results indicate that quantitative CEUS perfusion parameters could be useful tools for assessing the efficacy of TACE for HCC.
采用超声造影（CEUS）对肝细胞癌（HCC）患者经动脉化疗栓塞术（TACE）前后的微循环血流灌注进行定量分析。2013年6月至2015年10月，共招募了106例行TACE的HCC患者。在TACE前后进行CEUS，以确定HCC病灶及周围肝实质的时间-强度曲线（TIC）和灌注定量参数。使用感兴趣区域法获得定量灌注参数。用血液分析系统和微循环显微镜测量微循环血流灌注。通过CD34免疫组化检测肿瘤微血管密度（MVD）。与周围肝实质相比，HCC病灶的到达时间（AT）、达初始峰值时间（TTP）和加速时间更早，上升时间斜率（a3）更快，但平均通过时间（MTT）、下降至峰值一半的斜率（a2）、峰值强度（PI）、信号增强强度（ISI）、曲线下面积（AUC）和血流量（BF）无差异。TACE前后HCC病灶的PI、a3、ISI、AUC和BF有显著差异。TACE后HCC病灶的高切黏度、低切黏度、血浆黏度和全血黏度升高，但甲襞微循环速度降低。在50倍光镜下，高分化HCC病灶的MVD高于低分化HCC病灶。然而，在100倍和200倍光镜下，高分化和低分化HCC病灶的MVD无显著差异。低分化HCC病灶的PI、ISI、AUC和BF显著低于高分化HCC病灶，但AT、TTP、ACU、MTT、a2和a3无差异。总之，这些结果表明，CEUS定量灌注参数可能是评估TACE治疗HCC疗效的有用工具。
