肝细胞癌化疗栓塞期间肝动脉血流变化的三维定量彩色编码分析

Three-Dimensional Quantitative Color-Coding Analysis of Hepatic Arterial Flow Change during Chemoembolization of Hepatocellular Carcinoma.

作者信息

Lin Ethan Yiyang, Lee Rheun-Chuan, Guo Wan-Yuo, Wu Frank Chun-Hsien, Gehrisch Sonja, Kowarschik Markus

机构信息

Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan.

Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

J Vasc Interv Radiol. 2018 Oct;29(10):1362-1368. doi: 10.1016/j.jvir.2018.04.012. Epub 2018 Aug 28.

DOI:10.1016/j.jvir.2018.04.012

PMID:30170947

Abstract

PURPOSE

To evaluate feasibility of using three-dimensional (3D) quantitative color-coding analysis (QCA) to quantify substasis endpoints after transcatheter arterial chemoembolization of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

This single-institution prospective study included 20 patients with HCC who had undergone segmental or subsegmental transcatheter arterial chemoembolization between December 2015 and March 2017. The chemoembolization endpoint was a sluggish anterograde tumor-feeding arterial flow without residual tumor stains. Contrast medium bolus arrival time (BAT) was used as an indicator of arterial flow. BAT of the proper hepatic artery was obtained as a reference point. BATs of the proximal right lobar artery, proximal left lobar artery, and segmental artery that received embolization were analyzed before and after chemoembolization. Wilcoxon signed rank test was used to evaluate the difference between BATs before and after chemoembolization.

RESULTS

BATs before and after chemoembolization of the segmental artery that received embolization were 0.47 seconds (interquartile range [IQR], 0.31-0.70 s) and 1.04 seconds (IQR, 0.78-2.01 s; P < .001), respectively. BATs before and after chemoembolization of the proximal left lobar hepatic artery (0.35 s [IQR, 0.11-0.55] and 0.13 s [IQR, 0.05-0.32], P = .025) and right lobar hepatic artery (0.23 s [IQR, 0.13-0.65] and 0.22 s [IQR, 0.08-0.39], P = .027) exhibited no significant change.

CONCLUSIONS

3D QCA is a feasible method for quantifying sluggish segmental arterial flow after transcatheter arterial chemoembolization in patients with HCC.

摘要

目的

评估使用三维（3D）定量颜色编码分析（QCA）对肝细胞癌（HCC）经动脉化疗栓塞术后的亚稳态终点进行量化的可行性。

材料与方法

这项单机构前瞻性研究纳入了20例在2015年12月至2017年3月期间接受了节段性或亚节段性经动脉化疗栓塞的HCC患者。化疗栓塞终点为肿瘤供血动脉顺行血流缓慢且无残留肿瘤染色。对比剂团注到达时间（BAT）用作动脉血流的指标。以肝固有动脉的BAT作为参考点。对接受栓塞的右叶近端动脉、左叶近端动脉和节段动脉在化疗栓塞前后的BAT进行分析。采用Wilcoxon符号秩检验评估化疗栓塞前后BAT的差异。

结果

接受栓塞的节段动脉化疗栓塞前后的BAT分别为0.47秒（四分位间距[IQR]，0.31 - 0.70秒）和1.04秒（IQR，0.78 - 2.01秒；P < 0.001）。左叶近端肝动脉（0.35秒[IQR，0.11 - 0.55]和0.13秒[IQR，0.05 - 0.32]，P = 0.025）和右叶近端肝动脉（0.23秒[IQR，0.13 - 0.65]和0.22秒[IQR，0.08 - 0.39]，P = 0.027）化疗栓塞前后的BAT无显著变化。