CT与DSA综合影像在原发性肝癌经导管肝动脉化疗栓塞术后随访中的价值

The post-operative follow-up value of comprehensive imaging CT and DSA after TACE treatment of primary liver cancer

目的探讨CT与数字减影血管造影（DSA）应用于原发性肝癌经导管肝动脉化疗栓塞术（transcatheter arterial chemoembolization,TACE）术后随访的价值。方法对21例原发性肝癌经TACE术后生存期为1～5年患者的CT及DSA资料进行回顾性分析。结果碘化油（1ipiodol,LPD）沉积I型12例、Ⅱ型5例、Ⅲ型4例。CT发现6例栓塞周边复发,新发病灶5枚;DSA发现15例栓塞周边复发,新发病灶14枚。DSA在检出小病灶方面优于CT,差异有统计学意义（P〈0.05）。结论CT能够客观反应碘化油沉积;DSA在小病灶的检出方面较CT具有优势;CT、DSA并结合甲胎蛋白（AFP）的变化能及时发现小病灶,指导临床。

Objective To investigate the post-operative follow-up value of computed tomography（CT） and digital subtraction angiography（DSA） after transarterial chemoembolization（TACE） treatment of patients with primary liver cancer.Methods CT and DSA data of 21 patients with primary liver cancer after TACE whose postoperative survival period was 1-5 years were retrospectively analyzed.Results There were 12 cases with lipiodol deposition（（LPD） type I,5 cases with LDP type II and 4 cases with LDP type III.CT found that six cases had peripheral embolism recurrence and 5 new lesions.DSA found that 10 cases had peripheral embolism recurrence and 12 new lesions.Conclusion CT can objectively represent lipiodol deposition.Compared with CT,DSA has an advantage in detection of small lesions.Combination of CT and DSA as well as changes in AFP can discover the small lesions and guide the clinical performance.