论文部分内容阅读
目的评价CT和DSA在原发性肝癌TACE治疗后肿瘤残存和复发的诊断价值。方法对临床确诊45例原发性肝癌患者,分别于1～4次肝癌TACE治疗后1～6个月行CT和DSA复查,2项检查间隔时间为3～5d。分析和比较CT和DSA对肿瘤残存和复发的显示情况。结果碘油沉积形态可分3种类型:密整型,缺损型,稀少型。密整型9例(20.0%,9/45),CT与DSA6个月内复查均未见复发。缺损型32例(71.1%,32/45),32例中DSA示27例病灶残存或复发,CT双期动态增强扫描显示19例残存或复发,CT于动脉期见病灶显著强化者16例,门静脉期进一步强化者3例(提示有门静脉参与供血),DSA发现该区有明显染色及供血,另有8例CT与DSA表现不一致,CT双期增强无强化,但DSA可见肿瘤血供及肿瘤染色;稀少型4例(8.9%,4/45),CT双期增强轻度强化,DSA提示肿瘤为少血供。结论肝癌TACE治疗后CT平扫及双期增强CT扫描可作为显示肿瘤残存和复发的首选检查方法,DSA是观察肿瘤变化和评价疗效的最敏感和特异的方法;两者的结合对病灶的显示和后续治疗作出更好指导。
Objective To evaluate the diagnostic value of CT and DSA in the diagnosis and recurrence of tumor after TACE treatment of primary liver cancer. Methods A total of 45 patients with primary hepatocellular carcinoma were enrolled in this study. CT and DSA were performed 1 to 6 months after TACE treatment of 1 to 4 hepatocellular carcinoma (HCC) respectively. The interval between the two examinations was 3 to 5 days. Analysis and comparison of CT and DSA on tumor remnants and recurrence of the situation. Results Lipiodol deposition patterns can be divided into three types: dense type, defect type, rare type. Dense type in 9 cases (20.0%, 9/45), CT and DSA within 6 months of review no recurrence. There were 32 cases (71.1%, 32/45) of defect type and 27 cases of DSA remnant or recurrence in 32 cases. There were 19 cases of residual or recurrent CT in arterial phase, 16 cases of CT enhancement in arterial phase, DSA showed that there was obvious staining and blood supply in this area. Another 8 cases showed inconsistent CT and DSA manifestations and no enhancement in CT double stage, but DSA showed tumor blood supply and tumor 4 cases (8.9%, 4/45) in rare type, enhanced mild enhancement in both phases of CT, DSA suggested that the tumor was less blood supply. Conclusions CT scan and double-phase contrast-enhanced CT scan after TACE in hepatocellular carcinoma can be used as the first choice for detecting tumor remnant and recurrence. DSA is the most sensitive and specific method for observing tumor changes and evaluating the curative effect. The combination of the two shows the lesion And follow-up treatment to make better guidance.