超声造影、CT、DSA对肝癌肝动脉栓塞术后残存血供及后续治疗方案的评估作用

Evaluation of blood-supply and additional treatment in hepatic tumor after intervention therapy with ultrasonic angiography,CT and digital subtraction angiography

目的:探讨超声造影、CT、X线数字减影血管造影(DSA)对肝癌肝动脉栓塞术(TAE)后残存血供及后续治疗方案的评估作用。方法:对30例接受TAE的肝癌患者行超声造影、CT、DSA检查,对照结果。并对25例有残存血供者再次TAE后的碘油沉积情况进行比较。结果:30例中,5例三项检查均提示病灶灭活完全,无残留血供。19例三项检查均显示病灶残存血供丰富,再次TAE碘油沉积良好。6例CT显示病灶灭活无血供,超声造影显示病灶局部残存少量血供,DSA造影结果与超声造影相符,再次TAE碘油沉积不良。结论:超声造影对肝癌TAE后病灶残存血供的显示较CT更敏感、准确,与DSA相仿,且操作简便、无创。TAE后病灶的碘油沉积情况与血供相关,对于灭活不全但血供不丰富者,应选择更有效的治疗方法。

Objective：To evaluate the value of ultrasonic angiography, CT and x -ray digital subtraction angiography in assessing the blood - supply and additional treatment of hepatic tumor after transcatheter arterial embolization （TAE）. Methods： Changes of tumor blood- supply in 30 patients with hepatic tumor after treatment were examined by ultrasonic angiography, and the result were compared with findings by helical CT and DSA. TAE was carried out a- gain in 25 patients with tumor blood - supply remained after first treatment, and the retention of Lipidol was com- pared. Results： There were no blood - supply in 5 tumors showed by ultrasonic angiography, CT and DSA, and a large number in 19 tumors with Lipidol retention better after treatment again. There was a small amount of blood - supply demonstrated by ultrasonic angiography and DSA when no blood - supply demonstrated by CT in 6 tumors with few Lipidol retention after treatment again. Conclusion： Ultrasonic angiography can be well applicable for examination of blood - supply in hepatic tumor after TAE and guiding additional treatment in incomplete necrosis lesions. It is more sensitive, accurate, safe and easy when compared with helical CT and DSA.