肝癌介入治疗的影像评估价值──着重CT平扫及双期动态增强与DSA的影像对比分析  

Imaging Estimation of Hepatoma after Interventional Treatment

作　　者：郑金龙[1] 孔健[1] 冯敢生[1] 许林锋[1] 韩萍[1] 

机构地区：[1]同济医科大学附属协和医院放射科,武汉430022

出　　处：《临床放射学杂志》2000年第2期110-113,共4页Journal of Clinical Radiology

摘　　要：目的　探讨肝癌介入治疗后CT平扫及双期增强的评估价值及其意义。材料与方法　搜集 3 7例碘油栓塞及 7例微球栓塞患者复查CT平扫及双期增强图像 ,并与血管造影对比分析 ,了解栓塞区非坏死低密度灶的强化规律与供应血管的关系。结果CT平扫可分辨碘油沉积区、液化坏死区、非坏死低密度区。血管造影发现非坏死低密度区有残存肿瘤血管或 /和侧支供血。双期增强CT显示 :动脉期 ( 2 5～ 40秒 )明显强化时 ,该区肿瘤血管部分再通或 /和大量侧支循环形成 ;若门静脉期 ( 60～ 75秒 )进一步强化 ,可能还有门静脉参与供血 ;双期增强无明显强化者 ,该区供血动脉不丰富 ,门静脉很少参与供血。结论　CT应作为肝癌介入治疗后影像学复查的首选检查方法 ,其平扫及双期增强表现可反映栓后瘤体的组织学及供血变化 ,及时发现新病灶 ,据此制订新的治疗方案 ,有望提高疗效。Objective To evaluate the plain and dual phase enhanced CT scans of hepatoma after interventional treatment.Materials and Methods Plain and dual phase enhanced CT scan was performed in 37 patients who had received embolization with lipiodol and 7 patients who had received embolization with microspheres. The CT images were compared with the selective angiography. The relationship between enhanced CT features and the blood supply of the survival tumor was analyzed.Results The lipiodol deposition, liquefaction necrosis and survival tumor could be identified on plain CT scan. Residual tumor vessels and/or compensatory circulation were seen in the survival areas of tumor. Marked enhancement of the survival areas during hepatic arterial phase (25～40s) indicated partial racanalization of tumor vessels and/or the formation of collateral circulation. Further enhancement seen during portal venous phase (60～70s) represented additional blood supply from portal veins.Conclusion For reexamining of patients with hepatoma after receiving arterial embolization, CT is of the first choice. CT manifestations can reflect histologic components and blood supply of the tumor, and reveal new lesions as well.

关 键 词：肝癌 CT DSA 栓塞疗法 

分 类 号：R735.7[医药卫生—肿瘤]