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目的 研究微波凝固治疗肝细胞癌后的螺旋CT表现 ,评价CT征象与疗效之间的关系。方法 分析经超声引导下行微波凝固治疗的原发性肝细胞癌病人 2 2例、共 2 6个病灶的螺旋CT征象。结果 2 1个病灶肝动、门脉双期病灶内和边缘部均未见强化。 7个病灶肝动脉期病灶周围的肝组织见斑片状轻度至明显的强化。 5个病灶肝动脉期病灶内或病灶边缘部见结节样强化。结论螺旋CT的双期增强扫描可以准确地判断超声引导下微波凝固治疗肝细胞癌的治疗效果 ,当双期扫描病灶内无强化时 ,说明病灶无肿瘤残留 ;当动脉期病灶周围肝组织出现斑片状轻度至明显强化时 ,属于微波凝固治疗后的正常反应 ;当动脉期病灶内或病灶边缘部出现结节样强化时 ,说明病灶内肿瘤有残留复发。
Objective To study the spiral CT findings after microwave coagulation in the treatment of hepatocellular carcinoma and to evaluate the relationship between CT signs and therapeutic effect. Methods Twenty-two cases of primary hepatocellular carcinoma (HCC) treated by ultrasound-guided microwave coagulation were analyzed by spiral CT. RESULTS: No significant enhancement was found in 2 lesions of hepatic artery and portal vein both in the lesion and in the periphery. Seven lesions hepatic artery lesions around the liver tissue patchy mild to significant enhancement. Five lesions hepatic artery lesions or edge of the lesion see nodular-like enhancement. Conclusion Double-phase enhanced spiral computed tomography (CT) can accurately determine the therapeutic effect of ultrasound-guided microwave coagulation in the treatment of hepatocellular carcinoma. When there is no enhancement in the double-phase lesion, there is no residual tumor in the lesion. Flaky mild to significantly enhanced, belong to the normal reaction after microwave coagulation therapy; when the arterial phase lesions or edge of the nodular-like enhancement, indicating the tumor residual tumor recurrence.