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目的 探讨螺旋CT(SCT)对肝癌介入治疗的疗前评估与指导的意义。方法 对48例经SCT诊断肝癌的患者行SCT三期(动脉期、门脉期、平衡期)扫描,观察病灶特征,采用两种介入治疗方法:碘油加化疗药物和明胶海绵加化疗药物。治疗后15或30天复查SCT,观察碘油充填率和肿瘤大小来判断其疗效。结果 SCT显示有单支和多支动脉血供癌灶肝动脉超选择介入治疗效果显著,血供不丰富者则不佳。病变直径>5cm者和有动脉和门脉短路(APS)者宜选用明胶海绵加化疗药物,病变直径≤5cm者和无APS者宜选用碘油加化疗药物,SCT显示有单支动脉血供癌灶合并包膜效果最佳,有APS者碘油加化疗药效果不佳,应选择明胶海绵加化疗药。结论 SCT对肝癌介入治疗的疗前评估与指导有较大价值。
Objective To investigate the value of spiral CT (SCT) in preoperative evaluation and guidance of interventional treatment of liver cancer. Methods Forty-eight patients with hepatocellular carcinoma (SCT) diagnosed by SCT were screened for stage III (arterial phase, portal phase, balance period) SCT. The characteristics of the lesions were observed. Two interventional methods were used: lipiodol combined with chemotherapeutic drugs and gelatin sponge plus chemotherapeutic drugs. Fifteen or thirty days after treatment, SCT was performed to observe the effect of lipiodol filling rate and tumor size. Results SCT showed a single and multiple arterial blood supply of hepatic artery super-selective interventional treatment was significant, those who are not rich in blood are not good. Lesions> 5cm in diameter and artery and portal vein short circuit (APS) should use gelatin sponge plus chemotherapy drugs, lesions ≤ 5cm in diameter and no APS should choose lipiodol plus chemotherapy drugs, SCT showed a single artery for cancer Stomach combined with the best envelope, APO lipiodol plus chemotherapy drugs ineffective, gelatin sponge plus chemotherapy drugs should be selected. Conclusions SCT is of great value in preoperative assessment and guidance of interventional treatment of liver cancer.