摘要
目的采用多层螺旋CT(MSCT)平扫及增强双期扫描,研究原发性肝癌(HCC)经肝动脉灌注碘化油栓塞术(LPTACE)后肿瘤存活区(VTA)的血液供应,以期对再治疗方案和途径的选择提供有价值的信息。方法38例HCC患者共55个病灶,经57次LPTACE后行MSCT平扫及增强双期扫描,根据增强扫描不同时期的强化表现,将VTA的血液供应分为四种类型:肝动脉供血型、门静脉供血型、双重供血型及少血供型;统计各种血供类型的比例,并与术前肿瘤血供进行比较。结果38例患者行57次LPTACE后的肿瘤存活区在平扫表现为肿瘤内栓塞碘化油之间及周围非坏死低密度影,其CT值为(37.71±7.78)Hu。低密度肿瘤存活区有四种类型的血液供应,分别为:肝动脉供血型(29例)、门静脉供血型(2例)、双重供血型(22例)、少血供型(4例)。与术前肿瘤血供比较,门静脉参与供血有增加。结论HCC经LPTACE术后肿瘤存活区血供以肝动脉供血和肝动脉、门静脉双重供血为主,单纯门静脉供血及少血供较少。与LPTACE术前相比,门静脉对肿瘤存活区的供血有增加。
Objective To evaluate the blood supply of viable tumor area （VTA） of hepatocellular carcinoma （HCC） after transcatheter arterial chemoembolization using lipiodol （LP-TACE） by dual-phase multislice computed tomography （MSCT） scanning. Methods Thirty-eight patients with 55 HCCs after LP-TACE treatment were examined by plain scanning and hepatic dual-phase MSCT. The performance of VTA on plain scanning and the enhancement patterns on dynamic contrast-enhanced scanning were observed. In contrast-enhanced CT scans, the blood supply of VTA was classified into four types： arterial blood supply, portal blood supply, arterial together with portal blood supply and poor blood supply. At the same time, the attribution of portal venous blood supply to VTA was compared with that before LP-TACE. Results The VTA appear as a hypoattenuation lesion on unenhanced images, and the CT value of VTA was （37.71±7.78） Hu. In contrast-enhanced CT scans, the blood supply of VTA was classified into four types： arterial blood supply （29 cases）, portal blood supply （2 cases）, arterial together with portal blood supply （22 cases） and poor blood supply （4 cases）. The attribution of portal venous blood supply to VTA was significantly increased after LP-TACE. Conclusion Arterial blood supply and arterial together with portal blood supply are the two main types of the blood supply with VTA. The attribution of portal venous blood supply to VTA was significantly increased after LP-TACE.
出处
《中国介入影像与治疗学》
CSCD
2006年第3期195-200,共6页
Chinese Journal of Interventional Imaging and Therapy
