背景与目的:原发性肝癌经动脉导管栓塞化疗(transcatheterarterialchemo-embolization,TACE)联合射频消融(radiofrequencyablation,RFA)治疗后,CT扫描对判断是否有肿瘤残留存在一定的困难,而18FDG-PET/CT(18-fluorodeoxyglucose-positronemissiontomograply/CT)在判断肿瘤残留上具有优势。本研究对13例原发性肝癌经TACE联合RFA治疗周后,采用CT和18FDG-PET/CT检查是否存在肿瘤残留,分析CT和18FDG-PET/CT在判断肿瘤残留上的差异,并根据18FDG-PET/CT的结果指导肿瘤治疗。方法:本组13例原发性肝癌患者共有18个病变,肿瘤最长直径为0.8～16.0cm。12例为初治病例;1例为肝癌手术后复发,肝内共发现有3个病变。经过TACE联合RFA治疗后2～3周,对比CT和18FDG-PET/CT检查的结果;如发现有肿瘤残留,在2～3周内对其进一步行RFA治疗。结果:13例患者经一次TACE联合一次RFA治疗2～3周,经病变区域活检及数字减影血管造影等检查发现11例有部分肿瘤残留,肿瘤残留最长直径为1.0～2.1cm;CT增强扫描检查检出5例,18FDG-PET/CT检出有10例残留,CT与18FDG-PET/CT检出率分别为45.4%及90.9%。根据检查结果,在2～3周内经过第二次RFA治疗后,18FDG-PET/CT检查发现10例患者肿瘤无残留,另1例6周后复查18FDG-PET/CT发现肝内病变未控,患者带瘤生存。结论:原发性肝癌经TACE联合RFA治疗以及手术后,18FDG-PET/CT对判断肿瘤残留以及根据检查结果指导RFA治疗较CT检查具有更大的优势。 BACKGROUND & OBJECTIVE: CT scanning has some difficulties in determining the presence or absence of tumor residual after transcatheter arterial embolization (TACE) and radiofrequency ablation (RFA) treatment of primary liver cancer. However, 18FDG-PET / CT (18-fluorodeoxyglucose-positronemission tomograply / CT) has an advantage in determining tumor residue. In this study, 13 cases of primary hepatocellular carcinoma after TACE combined with RFA treatment weeks, the use of CT and 18FDG-PET / CT examination of the presence of tumor residues, analysis of CT and 18FDG-PET / CT in the determination of tumor residue differences, and according to 18FDG The results of PET / CT guide tumor therapy. Methods: The group of 13 patients with primary liver cancer a total of 18 lesions, the longest tumor diameter 0.8 ~ 16.0cm. 12 cases of newly diagnosed cases; 1 case of liver cancer recurrence after surgery, a total of 3 lesions were found in the liver. After TACE combined with RFA treatment 2 to 3 weeks, the contrast CT and 18FDG-PET / CT examination results; if there are tumor residues, in 2 to 3 weeks to further RFA treatment. Results: Thirteen patients were treated with one TACE combined with RFA for 2 to 3 weeks. The results of regional biopsy and digital subtraction angiography showed that some tumors were found in 11 patients and the longest tumor diameter was 1.0-2.1 cm. Five cases were detected by scanning examination. Ten cases were detected by 18FDG-PET / CT. The detection rates of CT and 18FDG-PET / CT were 45.4% and 90.9% respectively. According to the results of the examination, no tumor was found in 10 patients by 18FDG-PET / CT examination after the second RFA treatment in 2 to 3 weeks, and 18 cases in another 6 weeks after the 18FDG-PET / CT examination were found to be uncontrolled , Patients with tumor survival. Conclusion: 18FDG-PET / CT is more effective than CT in the diagnosis of primary liver cancer after TACE combined with RFA and surgery.