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目的探讨肝癌经肝动脉碘油化疗药物栓塞（ｔｒａｎｓｃａｔｈｅｔｅｒ ｏｉｌｙ ｃｈｅｍｏｅｍｂｏｌｉｚａｔｉｏｎ， ＴＯＣＥ）联合高强度聚焦超声（ｈｉｇｈ ｉｎｔｅｎｓｉｔｙ ｆｏｃｕｓｅｄ ｕｌｔｒａｓｏｕｎｄ， ＨＩＦＵ）治疗前、后的ＣＴ表现特点。方法 ５０例肝癌患者分别于ＴＯＣＥ联合ＨＩＦＵ治疗前、后行ＣＴ检查，测量病灶体积的大小，观察碘油潴留分布特点以及肿瘤密度、形态及边缘改变。结果治疗后 ３８例（３８／５０， ７６％）病灶体积缩小，单纯ＴＯＣＥ治疗与联合治疗后病灶体积缩小率差异有统计学意义（Ｐ＜０．０５）。病灶体积缩小率与碘油潴留量有关，与病灶大小无关。联合治疗后３０例（３０／５０，６０％）病灶密度降低，强化程度减弱。１６例病灶边缘变得更清晰规则。结论ＴＯＣＥ联合ＨＩＦＵ治疗肝癌能使肿瘤体积明显缩小，ＣＴ在判断疗效及预后方面具有重要价值。
Objective To investigate the CT features of hepatocellular carcinoma before and after transcatheter oily chemoembolization (TOCE) combined with high intensity focused ultrasound (HIFU) therapy. Methods 50 patients with hepatocellular carcinoma were examined by CT before and after TOCE combined with HIFU. The size of lesions was measured. The distribution of lipiodol retention and the changes of tumor density, morphology and margin were observed. Results After treatment, 38 cases (38/50, 76%) had reduced lesion volume, and the difference of lesion volume after TOCE treatment and combination therapy was statistically significant (P<0.05). The volume reduction rate of the lesion was related to the retention of lipiodol, and had nothing to do with the size of the lesion. After the combination therapy, the lesion density decreased in 30 cases (30/50, 60%), and the degree of enhancement weakened. The edges of the lesions became more clear and regular. Conclusions TOCE combined with HIFU can significantly reduce the tumor volume in the treatment of liver cancer. CT has important value in judging the curative effect and prognosis.