原发性肝细胞癌经动脉导管栓塞化疗联合射频消融术后的CT及MRI表现

Primary hepatocellular carcimoma after transcatheter arterial chemoembolization(TAC) with radiofrequency ablation(RFA): spectrum of CT and MR imaging findings

目的:回顾性评价原发性肝细胞癌(hepatocellular carcinoma,HCC)经肝动脉导管化疗栓塞(transcatheter ar-terial chemoembolizstion,TACE)联合射频消融术(radiofrequencr ablation,RFA)后的CT及MR表现。方法:回顾性收集2004年6月～2009年6月的肝癌病例42例(共49个病灶)进行了TACE联合RFA治疗。术后随访为3～24个月。用CT及MR评价肝内病灶的密度(信号)、强化方式、边界和大小等变化。结果:TACE联合RFA完全的病灶CT表现为不规则致密碘油沉积(高密度)和消融区域(低密度无强化)混合存在。MRI表现为T1WI等、高信号,T2WI等、低信号,增强扫描无强化。TACE联合RFA1个月之内行CT扫描的患者中,7个病灶术后存在片状或环行强化,复查消失。随访中,5例CT及3例MR表现为病灶体积增大或出现不规则强化,提示复发。结论:用CT或MRI对TACE联合RFA术后患者进行评价可以了解栓塞和射频消融是否完全或是否存在残留或复发。

Objective：To retrospective evaluate the usefulness of CT and MRI in hepatoeellular careimoma treated with transeatheter arterial chemoembolization （TACE） combined with radiofrequency ablation （RFA）. Methods： 42 Patients with 49 original HCC leisions from 2004, 6 to 2009, 6 were involved in this study. All patients underwent CT or MRI after TACE combined with RFA. CT or MRI performed in all patients in 3-24 months. The serial changes in intensity, enhancement pattern, shape and other findings were analyzed at follow-up CT or MRI. Results：TACE combined with RFA lesions demonstrated well-circumscribed areas at edge and hyperintensity in middle on CT. equal or low signal in middle of focus and low signal at edge on T2 WI. Equal or high signal at edge on T1 WI. Enhanced CT or MRI showed no enhancement. seven focus on CT demonstrated a thin enhancement rim around the central necrosis corresponding to hyperintensity on T1 WI and hypointensity on T2 WI. In the follow-up, five focus were suspected as recurrent or new tumors with CT and three with MRI, which demonstrated irregular enhancement or a large size. Conclusion：Follow-up CT and MRI of hepatocellular earcimoma treated with transcatheter arterial chemoembolization （TACE） combined with radiofrequency ablation （RFA） showed variable findings in the treated lesions and residual or recurrent tumors.