螺旋CT对肝细胞肝癌化疗性栓塞的近期疗效观察的价值探讨  

The exploration of the value of helical CT in evaluation of the recent curative effect of hepatocellular carcinoma(HCC) after chemotherapeutic embolization

作　　者：袁杰[1] 白晶[1] 刘俊 

机构地区：[1]泰安市第一人民医院CT室,山东泰安271000 [2]泰安市协和医院B超室,山东泰安271000

出　　处：《医学影像学杂志》2006年第10期1065-1067,共3页Journal of Medical Imaging

摘　　要：目的：探讨螺旋CT对肝细胞肝癌化疗性栓塞（TACE）近期疗效的评价作用。方法：回顾性分析30例，共36个病灶行TACE后近期（3～6个月）的CT变化，所有病例均经手术病理证实，着重观察病灶大小、坏死情况、碘化油沉积情况、有无复发。结果：栓塞化疗后3～6个月的CT变化：①病灶大小：变小30个病灶，占83．3％（30／36）；②碘化油分布情况：高浓度均匀分布18个病灶，占50％（18／36）；弥散分布16个病灶，占44．4％（16／36）；③病灶坏死程度：如完全无强化，则为完全坏死，8个病灶（22．2％）；坏死在50％～89％之间为不完全坏死，10个病灶（27．8％）；〈50％为部分坏死，12个病灶（33．3％）；④TACE（3～6个月）后，原病灶增大或出现新病灶为复发，4个病灶（11．1％）。TACE疗效与TACE前CT表现之间有一定联系，其中单一瘤灶包膜完整者，病灶均完全坏死，此类疗效最好，8个病灶（占22．2％）。CT平扫或增强检查观察病灶大小、碘化油分布情况、肿瘤坏死情况、有无复发病灶可作为TACE近期疗效的评价标准。结论：螺旋CT能简单而直观地反映肝癌化疗性栓塞的近期疗效。Objective：To disuss the value of helical CT in evaluation of the recent curative effect of hepatocellular carcinoma （HCC） after trascatheter arterial chemoembelization （TACE） in 3 -6 months. Methods： 30 cases, 36 lesions after TACE were retrospectively analysed, all the lesions were confirmed by operation and histopathology. Size of lesion, tumor necrosis, distribution of lipiedol and recurrence were carefifully analysed. Results： Changes of lesion after TACE in 3 - 6 months： ①Size of lesion： there were 30 lesions smaller than before, 83.3% （30/36） ; ②Distribution of lipiedol： homogeneous hyperattenuating 18 lesions （50%） or diffuse 16 lesions （44.4%） ;③ Degree of tumor necrosis：complete necrosis-there is completely no enhencement, 8 lesions （22.2 % ）; Incompletely necrosis in 50% - 90%, 10 lesions （27.8%）; Partly necrosis-〈 50%, 12 lesions （33.3%）; ④Recurrence of tumor： the lesion is bigger than before or some new lesions appear in 3 - 6 months, 4 lesions of 4 cases （ 11.1% ）. There is some relation between the effect of TACE and the features of helical CT. Single lesion and with integral envelope were all completely necrosis. It indicats that this type have the best curative evaluation, 8 lesions （22.2 % ）. By plain and enhanced CT, observe size of lesion, distribution of lipiedol, degree of tumor necrosis, recurrence may be the recent curative effect criteria of HCC after TACE. Conclusion： Helical CT follow-up the recent curative effect of hepatic tumor after transeatheter arterial embolization is simple and visual.

关 键 词：肝癌 肝动脉化疗栓塞术 体层摄影术 X线计算机 

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