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目的 评价多层螺旋CT(MSCT)在肝癌(HCC)介入治疗中的指导作用,着重研究对肝动脉化疗栓塞的价值。方法 对54例HCC患者先行MSCT检查,分别观察肝动脉期、门静脉期和肝静脉期肿瘤及其并发症的影像表现;其中12例行CTA检查,42例应用MIP或MPR观察腹腔动脉的解剖和走行,根据影像表现拟订治疗方案。结果 54 例患者MSCT发现HCC病灶225个,门静脉瘤栓10例,动静脉瘘14例。MSCT对肿瘤数目、门静脉瘤栓显示率与 DSA无显著差异 (P>0.05)。CTA对于显示腹腔动脉及其主要分支的解剖三维结构优于后前位 DSA,观察与腹主动脉夹角较 DSA更方便。MSCT发现肝动脉起源变异5例,与DSA完全符合。结论 MSCT对于肝癌肝动脉化疗栓塞有重要指导意义。
Objective To evaluate the role of multi-slice spiral CT (MSCT) in interventional therapy of hepatocellular carcinoma (HCC) and focus on the value of hepatic artery chemoembolization. Methods Fifty-four patients with HCC were examined by MSCT before and after operation. The imaging findings of hepatic artery, portal vein and hepatic vein tumor and its complications were observed. Twelve of them were examined by CTA and 42 were examined by MIP or MPR. Travel, according to the performance of the image to develop treatment options. Results In the 54 patients, there were 225 HCC lesions, 10 portal vein tumor emboli and 14 arteriovenous fistulas. MSCT showed no significant difference in the number of tumors and portal vein tumor thrombus (P> 0.05). CTA is superior to posterior DSA in displaying anatomic three-dimensional structure of celiac artery and its major branches, and it is more convenient to observe the angle with abdominal aorta than DSA. MSCT found five cases of hepatic artery variation, consistent with DSA. Conclusion MSCT has important guiding significance for hepatic arterial chemoembolization in patients with hepatocellular carcinoma.