弥漫型肝癌的CT、DSA诊断及介入性治疗(附14例报告)  

Imaging Diagnosis and Interventional Therapy of Diffuse Type Hepatic Cellular Carcinoma (A Report of 14 Cases )

作　　者：刘骏方[1] 龙清云[1] 胡金香[1] 鲁植艳[1] 卓德强[1] 

机构地区：[1]武汉大学中南医院放射科,湖北武汉430071

出　　处：《实用放射学杂志》2005年第1期68-71,共4页Journal of Practical Radiology

摘　　要：目的　认识弥漫型肝癌的影像学表现特点 ,探讨弥漫型肝癌介入治疗的最佳方法。方法　对 14例弥漫型肝癌进行了肝动脉造影及化疗栓塞治疗。治疗前根据肝癌的DSA、CT等影像学表现特点、血供及门脉情况、肝功能状况 ,选择适宜的介入治疗方法 ,经肝固有动脉注入化疗药及 /或栓塞剂。结果　①影像学表现 :14例弥漫型肝癌DSA及CT的主要表现有肿瘤血管密集增多 ,肿瘤染色广泛 ,呈弥漫分布的栗粒状、小斑点状或结节状影或密度减低区 ,左右叶均可受累 ,肝脏体积明显增大 ,明显肝硬化伴门脉瘤栓或动静脉瘘形成 ,弥漫性碘油分布等。②治疗效果 :14例中 ,生存期最长 10月 ,最短 15d ,平均 3月。结论　①“弥漫小结节征”、“毛玻璃征”、“双轨征”及“巨肝征”为弥漫型肝癌的较特征性表现。②弥漫型肝癌的介入治疗效果及预后远较其他类型原发型肝癌差。选择适宜的介入治疗方法可以延长患者的生存期。Objective To study the imaging features and adequate interventional therapy of the diffuse type hepatic cellular carcinoma(HCC).Methods Fourteen patients with the diffuse type HCC underwent hepatic angiography and the adequate interventional therapy by TAI or TAE according to imaging appearances,blood supply and function of liver.Results ①Imaging appearances:the most common appearances of fourteen patients with the diffuse type HCC on DSA and CT included:tumor blood vessel was extensive and increased,tumor stain was extensive in left and right liver leaf(such as grain,small spot ,nodule shadows or low density area),liver enlarged obviously with liver cirrhosis,portal vein tumor thrombus,arteriopotal shunt and widespreadly scattered iodized oil,et al.②Therapeutic effect:the mean survival time of fourteen patients was 3 months,the longest survival period was 10 months and the shortest one was olny 15 days.Conclusion ①The specific appearances of the diffuse type HCC are diffuse small spot-like,frosted glass-like,double orbit-like and big liver-like.②The interventional therapeutic effect and prognosis of the diffuse type HCC are the worst than that of other type primary hepatic carcinoma.Selecting adequate interventional therapeutical plan can obviously prolong survival time of the patient.

关 键 词：肝癌 影像学 介入治疗 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]