MSCT增强扫描在原发性肝癌TACE治疗前的价值研究

Value of enhancement scan of MSCT before treatment of primary hepatic carcinoma with TACE

目的探究多层螺旋CT(MSCT)增强扫描原发性肝癌(PHC)经肝动脉化疗栓塞术(TACE)术前的应用价值。方法回顾性分析该院60例PHC患者初次行TACE治疗前的MSCT增强图像,并行多层面重建(MPR)、容积再现(VR)、最大密度投影(MIP)后处理,以TACE术中造影结果为金标准,对比分析MSCT增强及后处理技术在显示肝动脉的形态及肝癌的血供方面的准确性。结果60例均清楚显示肝动脉走行、肝癌的血供情况,肝动脉变异8例,肝外动脉供血6例,均与TACE术中数字减影血管造影(DSA)结果一致;1、2级肝动脉显示VR、MIP差异无统计学意义(P>0.05);3级、4级差异有统计学意义(P<0.05),MIP明显优于VR。结论MSCT增强及后处理技术能良好地显示肝动脉的走行及肝癌的血供情况,在TACE治疗前起指导作用。

【objective】To study the value of multi-slice spiral CT(MSCT)enhanced scan of primary hepatocellular carcinoma(PHC)before transcatheter hepatic arterial chemoembolization(TACE).【Methods】The MSCT enhancement and multi-planar reconstruction(MPR),volume reproduction(VR),maximum intensity projection(MIP)post-processing images were retrospectively analyzed in 60 patients with PHC.Using TACE intraoperative angiography as the gold standard,the accuracy of MSCT enhancement and post-processing technique in showing the shape of hepatic artery and the blood supply of liver cancer was compared.【Results】Sixty cases all clearly showed hepatic artery walking and blood supply of liver cancer,8 cases of hepatic artery variation and 6 cases of extrahepatic artery blood supply were consistent with the results of digital subtraction angiography(DSA)in TACE operation;the difference of VR and MIP in grade 1 and 2 was not statistically significant(P>0.05);the difference between grade 3 and 4 was statistically significant(P<0.05),and MIP was significantly better than VR.【Conclusion】MSCT enhanced scan can well show the course of hepatic artery,the blood supply of liver cancer and portal vein tumor thrombus,which plays a guiding role before TACE treatment.