多层螺旋CT在肝癌介入治疗中的价值

Multislice spiral CT in interventional therapy of hepatocellular carcinoma

目的 评价多层螺旋CT(MSCT)在肝癌(HCC)介入治疗中的指导作用,着重研究对肝动脉化疗栓塞的价值。方法 对54例HCC患者先行MSCT检查,分别观察肝动脉期、门静脉期和肝静脉期肿瘤及其并发症的影像表现;其中12例行CTA检查,42例应用MIP或MPR观察腹腔动脉的解剖和走行,根据影像表现拟订治疗方案。结果 54 例患者MSCT发现HCC病灶225个,门静脉瘤栓10例,动静脉瘘14例。MSCT对肿瘤数目、门静脉瘤栓显示率与 DSA无显著差异 (P>0.05)。CTA对于显示腹腔动脉及其主要分支的解剖三维结构优于后前位 DSA,观察与腹主动脉夹角较 DSA更方便。MSCT发现肝动脉起源变异5例,与DSA完全符合。结论 MSCT对于肝癌肝动脉化疗栓塞有重要指导意义。

Objective To investigate the value of multislice spiral CT (MSCT) in interventional therapy of the hepatocellular carcinoma(HCC) emphasising on transcatheter hepatic arterial chemoembolization (TACE). Methods MSCT were performed in 54 cases of HCC before interventional procedure, CT findings of hepatic artery phase, portal venous phase and hepatic venous phase were observed respectively, among which CTA were done in 12 cases, and the anatomy of celiac artery and its branches were observed. The schemes of interventional therapy were worked out according to the findings of MSCT. Results MSCT showed 225 lesions, 10 cases of tumor thrombosis in portal vein, 1 case of hepatic arteriovenous shunt , and 13 cases of hepatic arterioportal shunt. There was no significant difference between MSCT and DSA in positive rate of in showing number of tumor or tumor thrombosis in portal vein ( P >0.05), but the 3D construction of celiac artery branches in CTA was better than that in DSA, while angles between celiac artery and abdominal aorta in MSCT were more convenient than that in DSA. MSCT showed 5 cases of hepatic artery original abnormality, in according with that in DSA. Conclusion MSCT is of importance for guidance of interventional therapy of the hepatocellular carcinoma.