多层螺旋CT和数字减影血管造影在肝癌肝动脉化疗栓塞中的价值

Multislice spiral CT and digital subtraction angiography in interventional therapy of hepatocellular carcinoma

目的研究多层螺旋CT（MSCT）在肝癌（HCC,）肝动脉化疗栓塞中的价值。方法对60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15例行CT动脉造影（CTA）检查，45例应用最大密度投影（MIP）或多平面重建（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60例患者发现HCC病灶250个，门静脉瘤栓10例，肝动静脉瘘19例。MSCT对肿瘤数目、门静脉瘤栓显示率与数字减影血管造影（DSA）差异无统计学意义（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Ⅸ淑完全符合。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 multisliee spiral CT （MSCT） in interventional therapy of the hepatocellular carcinoma（HCC） emphasising on transcatheter hepatic arterial chemoembolization（TACE）. Methods MSCT were performed in 60 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 15 cases, and the anatomy of celiacartery and its branches were observed in 45 cases. The schemes of interventional ther- apy were worked out according to the findings of MSCT. Results MSCT showed 250 lesions, 10 cases of tumor thrombosis in portal vein and 19 cases of hepatic arterioportal shunt. There was no significant difference between MSCT and digital subtraction angiography（DSA） in positive rate of in showing number of tumor or tumor thrombo- sis 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,according to that in DSA. Conclusion MSCT is of importance for guidance of interventional therapy of hepatocellular carcinoma.