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目的:探讨MSCT(multi-slice computed tomography)增强扫描在原发性肝癌TACE(Transcatheter Arterial Chemoembolization)术后近期疗效评价中的应用价值并行相关预测因素分析。方法:回顾分析2010年1月～2011年3月间我院确诊原发性肝癌并行TACE患者38例,术后1月内和6月后行MSCT三期增强扫描的肿瘤变化、碘油分布、血供情况和肿瘤内坏死等影像资料。评价TACE治疗后肿瘤结节的疗效,将这些影像表现与结节疗效作相关分析和多因素Logistic回归分析,建立预测原发性肝癌TACE后结节疗效CT征象模型。结果:38例患者共48个肿瘤结节经TACE治疗6月后,评价疗效发现肿瘤结节有效率68.8%(33个)。相关分析显示TACE治疗后肿瘤结节1月内碘油分布(r=0.688,P=0.000)、血供有无(r=-0.546,P=0.000)及肿瘤结节内坏死灶出现(r=0.433,P=0.002)与肿瘤结节TACE治疗后6月的疗效相关,Logistic回归分析表明TACE术后肿瘤结节内碘油分布和有无血供能预测肿瘤结节TACE后6月疗效。结论:MSCrT三期增强扫描能通过TACE后原发性肝癌肿瘤结节内碘油分布、有无血供来预测结节对治疗近期疗效,指导个性化治疗方案制定。
Objective: To investigate the application value of multi-slice computed tomography (MSCT) enhanced scan in the evaluation of short-term efficacy of TACE (Transcatheter Arterial Chemoembolization). Methods: Thirty-eight patients with TACE diagnosed with HCC from January 2010 to March 2011 were retrospectively analyzed. The changes of tumor, lipiodol distribution, Blood supply and tumor necrosis and other imaging data. To evaluate the curative effect of tumor nodules after TACE treatment, and to correlate these imaging findings with nodule curative effects and multivariate logistic regression analysis to establish a CT sign model for predicting the outcome of post-TACE nodules of primary liver cancer. Results: A total of 48 tumor nodules from 38 patients were treated by TACE for 6 months. The effective rate of tumor nodules was 68.8% (33). Correlation analysis showed that the distribution of lipiodol in the nodules of patients with TACE in January (r = 0.688, P = 0.000), no blood supply (r = -0.546, P = 0.000) 0.433, P = 0.002) were correlated with the curative effect of TACE after treatment for 6 months. Logistic regression analysis showed that the distribution of lipiodol in tumor nodules after TACE and the presence of blood supply predicted the curative effect of TACE after 6 months. Conclusion: MSCrT three-phase enhanced scanning can pass through the distribution of lipiodol in the nodules of primary liver cancer after TACE, with or without blood supply to predict the short-term curative effect of nodules and guide the development of personalized treatment plan.