| 付雪林,周建忠,黄国中,黄小宁,邓军.类CT灌注成像监测奥沙利铂所致肝窦损伤[J].中国医学影像技术,2022,38(1):93~97 |
| 类CT灌注成像监测奥沙利铂所致肝窦损伤 |
| Simulated CT perfusion imaging for monitoring oxaliplatin-induced hepatic sinusoid injury |
| 投稿时间：2021-01-30 修订日期：2021-07-26 |
| DOI：10.13929/j.issn.1003-3289.2022.01.022 |
| 中文关键词: 奥沙利铂 化学和药物性肝损伤 灌注成像 体层摄影术,X线计算机 |
| 英文关键词:oxaliplatin chemical and drug induced liver injury perfusion imaging tomography, X-ray computed |
| 基金项目:江西省卫生健康委科技计划(202130388)。 |
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| 中文摘要: |
| 目的 评价类CT灌注成像(CTPI)监测奥沙利铂(OXA)化疗致肿瘤患者肝窦损伤的价值。方法 纳入128例接受OXA化疗的胃癌或结直肠癌患者,测量其肝脏门静脉灌注量(PVP)、动脉增强分数(AEF)及脾脏体积,比较化疗前、化疗中期(第2~4周期)及化疗末期(第6~8周期)各参数差异;记录化疗前后各时期血小板(PLT)、谷丙转氨酶(GPT)及谷草转氨酶(GOT),并计算GOT/PLT比值及基于4因子的纤维化指数(FIB-4),比较各时期临床指标差异。采用Spearman相关性分析评价类CTPI参数与临床指标的相关性。结果 化疗各期PVP均较化疗前明显降低(P均＜0.05),脾脏体积均较化疗前明显增大(P均＜0.05),而AEF差异无统计学意义(P均＞0.05)。相比化疗前,化疗后PLT明显降低(P＜0.05),GOT、GPT、GOT/PLT比值及FIB-4明显升高(P均＜0.05)。PVP变化与GOT/PLT比值、FIB-4及脾脏体积均呈负相关(r=-0.18、-0.28、-0.34,P均＜0.05)。结论 OXA化疗后类CTPI参数PVP明显降低,且与反映肝窦损伤的实验室指标及脾脏体积变化相关,可作为评估肝窦损伤的敏感指标。 |
| 英文摘要: |
| Objective To observe the value of simulated CT perfusion imaging (CTPI) in monitoring hepatic sinusoid injury in patients with malignant tumor after chemotherapy with oxaliplatin (OXA).Methods A total of 128 patients with gastric or colorectal cancer who received OXA chemotherapy were collected. The hepatic portal venous perfusion (PVP), arterial enhancement fraction (AEF) and spleen volume were measured using a post-processing software, and the parameters before chemotherapy, at the middle stage of chemotherapy (cycle 2-4) and at the end of chemotherapy (cycle 6-8) were compared. Platelet (PLT), glutamic-pyruvic transaminase (GPT) and glutamic-oxaloacetic transaminase (GOT) were measured before and after chemotherapy, and GOT/PLT ratio and fibrosis index based on four factors (FIB-4) were calculated, and the clinical indexes in each cycle were compared. Spearman correlation analysis was used to evaluate the correlations of simulated CTPI parameters and clinical indexes.Results Compared with before chemotherapy, PVP were significantly lower, and the volumes of spleen were significantly larger during chemotherapy (all P＜0.05), but AEF were not significantly changed (all P＞0.05). PLT after chemotherapy was significantly lower than that before chemotherapy (P＜0.05), while GOT, GPT, GOT/PLT ratio and FIB-4 were significantly higher than those before chemotherapy (all P＜0.05). The changes of PVP were negatively correlated with GOT/PLT ratio, FIB-4 and spleen volume (r=-0.18, -0.28, -0.34, all P＜0.05).Conclusion As a simulated CTPI index, PVP significantly decreased after chemotherapy with OXA and related to the laboratory index of hepatic sinusoid injury and changes of spleen volume, which might be a sensitive index for evaluating hepatic sinusoid injury. |
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