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目的探讨比较肝癌术前CT,MRI,超声显像的结果与DSA及术中所见,探讨和分析其术后的复发的有关原因。方法在1991～2003.5作者对入院手术切除肿瘤最大径≤5cm的283例肝癌进行前瞻性对照研究。结果283例中CT、MRI、超声显像为单个的而DSA发现21.2%为2个或2个以上病灶,在手术探查中有32.5%2个或2个以上病灶。本组1、3、5年总生存率,无瘤生存率分别为93.2%、67.3%、50.1%和70.1%、57.7%、35.2%。本组肝癌术后第1年内复发占29.9%、第3年内占42.3%、5年内复发率为64.8%。结论影像学对肝癌的诊断非常重要。各种影像学检查方法均有其优、缺点,要提高诊断率,常常要结合多种影像学检查方法。DSA可弥补CT或MRI和超声检查的不足,然而部分小转移灶也难于发现。
Objective To compare the results of preoperative CT, MRI and ultrasonography of hepatocellular carcinoma with those of DSA and intraoperative findings, and to explore and analyze the related causes of postoperative recurrence. Methods From 1991 to 2003.5, we performed a prospective and controlled study of 283 cases of hepatocellular carcinoma (HCC) with the largest diameter ≤ 5 cm. Results CT, MRI and ultrasonography were single in 283 cases, and 21.2% were two or more lesions in DSA. There were 32.5% 2 or more lesions in surgical exploration. The 1, 3, 5-year overall and tumor-free survival rates were 93.2%, 67.3%, 50.1% and 70.1%, 57.7% and 35.2% respectively. The recurrence rate of liver cancer in this group was 29.9% in the first year, 42.3% in the third year, and 64.8% in five years. Conclusion Imaging diagnosis of liver cancer is very important. A variety of imaging methods have their advantages and disadvantages, to improve the diagnostic rate, often combined with a variety of imaging methods. DSA can make up for the lack of CT or MRI and ultrasound, however, some small metastases are difficult to find.