肝癌治疗前影像学结果的临床探讨

Clinical Study on the results of imaging before the treatment of liver cancer

目的探讨比较肝癌术前CT,MRI,超声显像的结果与DSA及术中所见,探讨和分析其术后的复发的有关原因。方法在1991～2003.5作者对入院手术切除肿瘤最大径≤5cm的283例肝癌进行前瞻性对照研究。结果283例中CT、MRI、超声显像为单个的而DSA发现21.2%为2个或2个以上病灶,在手术探查中有32.5%2个或2个以上病灶。本组1、3、5年总生存率,无瘤生存率分别为93.2%、67.3%、50.1%和70.1%、57.7%、35.2%。本组肝癌术后第1年内复发占29.9%、第3年内占42.3%、5年内复发率为64.8%。结论影像学对肝癌的诊断非常重要。各种影像学检查方法均有其优、缺点,要提高诊断率,常常要结合多种影像学检查方法。DSA可弥补CT或MRI和超声检查的不足,然而部分小转移灶也难于发现。

Objective To investigate the results of preoperative imaging and intraoperative findings in the diagnosis of liver cancer. Methods From 1991 to May 2003,283 cases with liver cancer （tumor size ≤5cm in diameter） received operative resection were studied prospectively and comparatively.Results In the 283 cases,a single nodule was found in the CT,MRI and B-US examination.However,2 or more than 2 nodules were found in 21.2% in the DSA examination and 2 or more than 2 nodules were found in 32.5% during operative exploration. The survival rate and free tumor survival rate of 1, 3, 5 years were 93.2%, 67.3%, 50.1% and 70.1%, 57.7%, 35.2% respectively.The 1,3,5 years postoperative recurrence rate were 29.9%, 42.3% and 64.8% respectively. Conclusion Imaging is very important for the diagnosis of liver cancer.For improving the diagnostic rate,combination of multiple imaging examination is neceesary frequently.The DSA can make up deficiency of CT,MRI and B-US examination.while,it is very difficult to find the partial minor metastatic lesions.