目的 研究功能CT对肝癌患者肝 储备功能与介入治疗风险关系的评估价 值。方法 选取2012年3月至2015年10月 期间广州医科大学附属第四医院及广州 医科大学附属第二医院的64例原发性肝 癌患者，均保留完整的临床治疗及CT影 像资料。入选患者均接受肝动脉化疗栓 塞术(TACE)介入治疗，且在TACE术前均 给予双期增强扫描并行CT肝硬化分级。 TACE术后1个月通过检测血清总胆红素 (TBIL)、血清白蛋白(ALB)等指标评价肝 功能损害情况，回顾性观察TACE术后肝 功能重度受损组(记为A组，23例)和肝功 能轻度受损组(记为B组，41例)的CT影像 数据资料，进一步比较不同CT肝硬化分 级患者的2年生存率及吲哚氰绿潴留率 (ICGR15)差异。结果 A、B两组TACE前CT 扫描肝灌注参数数HAP、PVP、TLP、HBF 均存在显著差异(P<0.05)；CT肝硬化分 级：I级12例，II级28例，III级16例， IV级8例，预后分析显示CT肝硬化I-II级 患者ICGR15(7.45±2.14)%、2年随访生 存率72.5%(29/40)均优于III-IV级患者 (16.22±3.16)%、45.8%(11/24),差异显 著(P<0.05)。结论 功能CT扫描肝灌注参 数、CT肝硬化分级能较好的评估肝储备功 能和TACE风险，为肝储备功能及临床治疗 提供重要评估依据。

Objective To study the evaluation value of functional CT in relationship between hepatic functional reserve and interventional therapy risk in patients with liver cancer. Methods Sixty-four patients with primary hepatic cancer treated were selected in the Fouth Affiliated Hospital Of Guangzhou Medical University and the Second Affiliated Hospital of Guangzhou Medical University from Mar. 2012 to Oct. 2015. All clinical treatment and CT image data were persisted. All patients were treated with chemotherapy hepatic artery embolization (TACE) interventional therapy, and before TACE dual-phase enhancement and CT grading of liver cirrhosis were performed. Serum total bilirubin (TBIL), serum albumin (ALB) and other indicators were detected to evaluate damage of liver function 1 months after TACE, after TACE a retrospective observation of CT image data was carried out in severe damage of liver function group (group A, 23 cases) and mild damage of liver function group (group B, 41 cases), the differences of 2-year survival rate and indocyanine green retention rate (ICGR15) of different CT grading of liver cirrhosis patients were further compared. Results There were significant differences in CT scan hepatic perfusion parameters HAP, PVP, TLP, HBF in the group A and group B before TACE (P<0.05). CT grading of liver cirrhosis was as follow: grade I 12 cases, grade II 28 cases, grade III 16 cases, grade IV 8 cases, prognosis analysis showed that ICGR15 and 2-year follow-up survival rate of CT liver cirrhosis grade I-II patients were respectively (7.45±2.14)% and 72.5% (29/40) which were significantly better than those in grade III—IV patients (16.22±3.16)% and 45.8% (11/24) (P<0.05). Conclusion Functional CT scan hepatic perfusion parameters and CT grading of liver cirrhosis can not only evaluate hepatic functional reserve and TACE risk, but also provide important evaluation basis for hepatic functional reserve and clinical treatment.