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中华肝脏外科手术学电子杂志

中华肝脏外科手术学电子杂志 ›› 2018, Vol. 07 ›› Issue (01) : 53 -56. doi: 10.3877/cma.j.issn.2095-3232.2018.01.014

所属专题： 文献；

临床研究

增强CT及增强MRI图像融合技术在原发性肝癌治疗决策中的价值
唐建信1, 李星2, 邢艳芳3, 刘尚鑫4, 吴晨飞4, 江文钊4, 陈明4, 莫嘉辉4, 吴伟坤4, 吴祥元2, 姜楠1,†()   
  1. 1. 510630　广州，中山大学附属第三医院肝脏外科
    2. 510630　广州，中山大学附属第三医院肿瘤内科
    3. 510150　广州医科大学附属第三医院肾内科
    4. 510080　广州，中山大学中山医学院
  • 收稿日期:2017-10-17 出版日期:2018-02-10
  • 通信作者: 姜楠
  • 基金资助:
    国家自然科学基金(81572368); 广东省自然科学基金(2016A030313278，2016A030313302，2014A030313146); 广东省科技计划项目(2014A020212084)

Value of enhanced CT and enhanced MRI image fusion in treatment decisions for primary liver cancer

Jianxin Tang1, Xing Li2, Yanfang Xing3, Shangxin Liu4, Chenfei Wu4, Wenzhao Jiang4, Ming Chen4, Jiahui Mo4, Weikun Wu4, Xiangyuan Wu2, Nan Jiang1,†()   

  1. 1. Department of Hepatic Surgery, The third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
    2. Department of Medical Oncology, The third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
    3. Department of Nephrology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
    4. Sun Yat-sen University of Medical Sciences, Guangzhou 510080, China
  • Received:2017-10-17 Published:2018-02-10
  • Corresponding author: Nan Jiang
  • About author:
    Corresponding author: Jiang Nan, Email:
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引用本文：

唐建信, 李星, 邢艳芳, 刘尚鑫, 吴晨飞, 江文钊, 陈明, 莫嘉辉, 吴伟坤, 吴祥元, 姜楠. 增强CT及增强MRI图像融合技术在原发性肝癌治疗决策中的价值[J]. 中华肝脏外科手术学电子杂志, 2018, 07(01): 53-56.

Jianxin Tang, Xing Li, Yanfang Xing, Shangxin Liu, Chenfei Wu, Wenzhao Jiang, Ming Chen, Jiahui Mo, Weikun Wu, Xiangyuan Wu, Nan Jiang. Value of enhanced CT and enhanced MRI image fusion in treatment decisions for primary liver cancer[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2018, 07(01): 53-56.

目的

探讨增强CT及增强MRI的图像融合技术在原发性肝癌（肝癌）治疗决策中的作用。

方法

回顾性分析2013年1月至2015年1月在中山大学附属第三医院接受诊治的55例肝癌患者临床资料。男42例，女13例；年龄18～84岁，中位年龄52岁。患者均签署知情同意书，符合医学伦理学规定。所有患者行增强CT扫描和钆塞酸二钠（Gd-EOB-DTPA）增强MRI扫描，采用基于有限元的柔性配准方法融合CT和MRI图像。由肝癌多学科会诊平台对患者的治疗决策进行讨论决定，每例患者进行2次讨论，首次基于增强CT图像，第2次基于融合图像。观察并分析治疗决策变更。

结果

基于增强CT图像的治疗决策包括根治性治疗8例、姑息性手术治疗35例、全身性药物治疗12例。基于融合图像的治疗决策包括根治性治疗4例、姑息性手术治疗36例、全身性药物治疗15例。基于融合图像的治疗决策较基于增强CT图像在根治性治疗、姑息性手术治疗、全身性药物治疗的转换率分别为50%（4/8）、3%（1/35）、25%（3/12）。

结论

增强CT和Gd-EOB-DTPA增强MRI的图像融合技术改变了部分肝癌患者的治疗决策，对优化治疗方案有一定的价值。

关键词: 肝肿瘤, 体层摄影术, 磁共振成像, 钆塞酸二钠, 图像融合
Objective

To explore the effect of enhanced CT and enhanced MRI image fusion technique in making treatment decisions for primary liver cancer (PLC).

Methods

Clinical data of55 patients with PLC who were treated in the Third Affiliated Hospital of Sun Yat-sen University between January 2013 and January 2015 were analyzed retrospectively. There were 42 males and 13 females, aged from 18-84 and with a median age of 52 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. All the patients underwent enhanced CT and gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced MRI. CT and MRI images were fused by using flexible registration method based on finite element. Treatment decisions for these patients were discussed and made by HCC multidisciplinary consultation group. Discussion was conducted twice for each patient. The first discussion was based on enhanced CT images and the second was based on fused images. Changes of treatment decisions were observed and analyzed.

Results

Treatment decisions based on enhanced CT images included radical treatment in 8 cases, palliative surgical treatment in 35 cases and systemic medicine treatment in 12 cases. Treatment decisions based on fused images included radical treatment in 4 cases, palliative surgical treatment in 36 cases and systemic medicine treatment in 15 cases. Compared with those based on enhanced CT images, the conversion rate of radical treatment, palliative surgical treatment and systemic medicine treatment based on fused images was respectively 50%(4/8), 3%(1/35) and 25%(3/12).

Conclusions

Enhanced CT and Gd-EOB-DTPA enhanced MRI image fusion can change the treatment decisions for some patients with HCC, and it is of certain significance in optimizing the treatment protocols.

Key words: Liver neoplasms, Tomography, Magnetic resonance imaging, Gadolinium ethoxybenzyl diethyle-netriaminepentaacetic acid, Image fushion
图1 基于增强CT图像和融合图像的治疗决策差异
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