TACE和PCS治疗原发性肝癌的多层螺旋CT评价

Double chemoembolization of hepatic carcinoma by TACE and portal vein PCS:the evaluation of MSCT volumetric measurement

为探讨多层螺旋CT(multi-slice CT,MSCT)体积测量在评价原发性肝癌经肝动脉和门静脉双重栓塞治疗的价值,将经肝动脉化疗栓塞术(transarterial chemoembolization,TACE)联合经门静脉导管药盒系统置入术(port catheter system,PCS)双重治疗的,不能手术切除的26例原发性肝癌患者作为A组,另选取30例单纯行TACE治疗的原发性巨块型肝癌患者为B组,测量A、B组治疗前1d和治疗后2个月的肿块体积变化率和正常肝实质体积变化率。A组患者均顺利地完成了经TACE联合经门静脉PCS双重栓塞治疗,并获得了较好的疗效,体积变化率为(-2.57±8.43)%,B组的体积变化率为(9.76±7.62)%,两组间差异有统计学意义,P<0.05。A组的正常肝实质体积为(12.28±11.29)%,B组为(-10.35±14.61)%,两组间差异有统计学意义,P<0.01。初步研究结果提示,MSCT体积测量可直观地评价原发性肝癌经肝动脉和门静脉双重栓塞的治疗效果。

The objective of this study was to evaluate the efficacy of double chemoembolization of primary hepatocellular carcinoma （HCC） by transcatheter arterial cheomembolization （TACE） and portal vein port catheter system （PCS） with MSCT volumetric measurement. In the test group A, PCS was implanted in portal vein in 26 cases of irresectable primary HCC during the operation. In all of the 26 cases, TACE was performed. Two weeks later, chemo embolization of portal vein via PCS was also done. A total of 30 cases of HCC treated simply with TACE were served as the control group B. The MSCT volumetric changing rate of the tumor and normal hepatic parenchyma were measured before TACE 1 day and 2 months after TACE in all the patients. Double chemoembolization by TACE and portal vein PCS was a safe procedure with high technique success rate and therapeutic efficacy for irresectable hepatic carci noma. There were statistical difference in the MSCT volumetric changing rate of the tumor and normal hepatic paren chyma between the Group A and Group B. The MSCT volumetric changing rate of the tumor in Group A was （-2.57±8.43）%, and （9.76±7.62）% in GroupB. The MSCT volumetric changing rates of the normal hepatic parenchyma in Group A and GroupBwere （12.28±11.29）%, and （-10.35±14.61）% , respectively. In conclusion, MSCT volumetric measurement can directly reflect the efficacy of double chemoembolization of HCC by TACE and portal vein PCS.