Prognostic significance of contrast-enhanced CT attenuation value in extrahepatic cholangiocarcinoma
Prognostic significance of contrast-enhanced CT attenuation value in extrahepatic cholangiocarcinoma
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DOI：
10.1007/s00330-016-4621-y
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发表时间：
2017-06-01
影响因子：
5.9
通讯作者：
Honda, Hiroshi
中科院分区：
文献类型：
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作者：
Asayama, Yoshiki;Nishie, Akihiro;Honda, Hiroshi
为探讨肝外胆管细胞癌（EHC）动态增强CT扫描的洗脱特征能否预测患者的生存期，收集了46例手术切除的EHC患者。所有病例均行多层螺旋CT动态增强扫描。在肿瘤的非增强、门静脉期和延迟期获得感兴趣区域的测量值，并用于计算洗脱率，如下所示：[（门静脉期CT的衰减值-延迟增强CT的衰减值）/（门静脉期CT的衰减值-未增强CT的衰减值）] x 100。根据中位洗脱率，我们将病例分为两组，高洗脱组和低洗脱组。分析了总生存率与各种因素（包括洗脱率）之间的关系，中位洗脱率为29.4%。单因素分析显示，较低的洗脱率、静脉浸润、淋巴管浸润和淋巴结转移与较短的生存期相关。多因素分析表明较低的洗脱率是独立的预后因素（风险比，3.768; p值，0.027）。从对比度中获得的洗脱比-增强CT扫描可作为预测EHC患者生存的一个有用的影像学标志物，动态增强扫描可评估肝外胆管癌的侵袭性，低洗脱率是EHC患者预后的一个独立指标。总生存率的影响因素。欧洲中心CT可以预测生存率，并为手术选择或化疗提供信息。
To determine whether washout characteristics of dynamic contrast-enhanced computed tomography (CT) could predict survival in patients with extrahepatic cholangiocarcinoma (EHC).This study collected 46 resected cases. All cases were examined by dynamic contrast study on multidetector-row CT. Region-of-interest measurements were obtained at the non-enhanced, portal venous phase and delayed phase in the tumour and were used to calculate the washout ratio as follows: [(attenuation value at portal venous phase CT - attenuation value at delayed enhanced CT)/(attenuation value at portal venous phase CT - attenuation value at unenhanced CT)] x 100. On the basis of the median washout ratio, we classified the cases into two groups, a high-washout group and low-washout group. Associations between overall survival and various factors including washout rates were analysed.The median washout ratio was 29.4 %. Univariate analysis revealed that a lower washout ratio, venous invasion, lymphatic permeation and lymph node metastasis were associated with shorter survival. Multivariate analysis identified the lower washout ratio as an independent prognostic factor (hazard ratio, 3.768; p value, 0.027).The washout ratio obtained from the contrast-enhanced CT may be a useful imaging biomarker for the prediction of survival of patients with EHC.aEuro cent Dynamic contrast study can evaluate the aggressiveness of extrahepatic cholangiocarcinoma.aEuro cent A lower washout ratio was an independent prognostic factor for overall survival.aEuro cent CT can predict survival and inform decisions on surgical options or chemotherapy.