TOCE联合HIFU治疗原发性肝癌的DSA检查及意义

The DSA Appearances and Its Significance of HCC after TOCE Combining with HIFU Therapy

目的 评价TOCE联合HIFU治疗原发性肝癌的DSA表现及意义。方法 5 0例原发性肝癌患者接受TOCE联合HIFU治疗 ,比较治疗前后的DSA表现。随机选出同期 5 0例单纯TOCE治疗的患者进行对照研究。结果 研究组与对照组治疗后肿瘤血管减少、消失、不变及增多分别为 76 % (38/ 5 0 )、8% (4 / 5 0 ) ;16 % (8/ 5 0 )、0 ;6 0 % (30 /5 0 )、4% (2 / 5 0 ) ;30 % (15 / 5 0 )、6 % (3/ 5 0 ) (P <0 .0 5 )。病灶体积缩小分别为 76 % (38/ 5 0 )和 5 8% (2 9/ 5 0 ) (P <0 .0 5 )。新病灶形成分别为 4例和 6例。侧支开放为 2例和 3例。结论 TOCE联合HIFU是治疗中晚期原发性肝癌的一种有效的治疗方法 ,DSA可以准确判断治疗后肿瘤大小、血供情况 ,早期发现复发及转移灶 。

Objective To study the DSA appearances and its significance of hepatocellular carcinoma(HCC) after transcatheter oily chemoembolization(TOCE) combining with high intensity focused ultrasound(HIFU)therapy. Methods 50 cases clinically proved liver cancer were underwent TOCE plus HIFU therapy, the DSA appearances were observed before and after combined therapy. Another 50 cases received simple TOCE therapy were randomly chosen as a control group. Results Decrease, disappear, dischange and increase of the tumor vessels in the studied group were 76%(38/50), 8%(4/50), 16%(8/50), 0 respectively,while 60%(30/50), 4%(2/50), 30%(15/50), 6%(3/50)in the control group( P <0.05).There were 76%(38/50) and 58%(29/50)lesions became smaller after combining treatment in the two groups respectively( P <0.05). New lesions were found in 4 and 6 cases. Compensatory circulation were seen in 2 and 3 cases. Conclusion TOCE combining with HIFU therapy is an effective and practical treatment for HCC. DSA manifestation can evaluate the volume and blood supply of the tumor, and reveal new lesions as well. DSA is of great value in the evaluation of effective and retherapy.