平板探测器CT灌注成像在肝癌TACE治疗中实时动态监测肿瘤血流动力学状态的研究

项目名称： 平板探测器CT灌注成像在肝癌TACE治疗中实时动态监测肿瘤血流动力学状态的研究

项目编号： No.81201172

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 影像医学与生物医学工程

项目作者： 庄治国

作者单位： 上海交通大学

项目金额： 23万元

中文摘要： 肝癌是威胁人类健康的主要恶性肿瘤之一，肝动脉化疗栓塞（TACE）是肝癌的主要介入治疗手段。TACE的主要原理是通过栓塞肿瘤供血动脉以达到使肿瘤缺血坏死的目的，其缺点之一是难以控制肿瘤的栓塞程度，栓塞疗效评估缺乏可靠的衡量指标。通过平板探测器C型臂血管造影系统可得到类似传统CT的组织血流灌注参数图，故本研究拟利用此项技术测量兔VX2肝癌TACE前后的血流灌注参数变化，分析该灌注参数与传统CT灌注成像所得灌注值间的关系，实时动态监测肿瘤栓塞程度，评估不同栓塞程度与肿瘤内部血流动力学改变和预后之间的关系，评价TACE后肿瘤的进展情况，寻找最佳的栓塞终点，并将此新技术初步运用于临床行TACE治疗的肝癌患者，为该技术的临床推广提供理论和实践基础。本研究项目的成功将会为肝癌的TACE治疗提供新的评估和监测体系，对于提高肝癌治疗效果具有深远的临床意义。

中文关键词： 平板探测器；灌注；肝细胞癌；血容量；肝动脉化疗栓塞

英文摘要： Hepatocellular carcinoma (HCC) is one of major malignant tumors that threaten human health. Transarterial chemoembolization (TACE) is the primary intervention treatment for hepatocellular carcinoma. TACE necrotizes tumor tissues by embolization of tumor feeding artery. However, one drawbacks of TACE is that it is difficult to control the degree of embolization,and there is lack of reliable guide line to evaluate embolization efficacy. Flat Detector (FD) equipped angiographic systems are increasingly used in daily routine recently. The introduction of FD equipped C-arm systems improved 3-D imaging with the possibility to obtain high-quality 3-D vascular imaging. Using this equipment, it is now possible to obtain CT like images (Flat Detector computed tomography, FD-CT) within the angio suite. There have been some evidences that FD-CT could provide a means to measure the cerebral hemodynamics at accuracy comparable to that of CT perfusion imaging. The ability to measure cerebral perfusion in an angiographic suite where it is possible to use immediately all available therapeutic techniques might, simply by saving time from initial assessment to intervention, add value to the management of patients with ischemic strokes. As a result, it is not unreasonable to propose that hepatic hemodynamics may be observed by FD-

英文关键词： flat detector；perfusion；hepatocellular carcinoma；blood volume；transarterial chemoembolization