16层螺旋CTA对原发性肝癌介入治疗的临床应用价值

目的探讨多层螺旋CT血管造影（MSCTA）及三维重建对原发性肝癌（HCC）介入治疗的指导、治疗效果及肿瘤活性评价的临床应用价值。资料与方法65例（病理诊断17例,临床诊断48例）HCC患者均进行MSCTA检查,CTA后处理技术包括多平面重建（MPR）、最大密度投影（MIP）和容积重建（VRT）等。观察HCC介入治疗前后肿瘤供血类型与碘油沉积、瘤体大小变化的相关性,以明确治疗效果并指导治疗方案的选择。结果 65例HCC患者共进行MSCTA186次,发现肝动脉解剖变异9例,肝外供血动脉55支,病灶碘化油沉积残缺26例,病灶明显缩小38例。病灶碘化油沉积、病灶大小变化与出现肝外动脉供血有明显的负相关（P〈0.001）。结论 MSCTA能直观、清晰的显示肿瘤病灶的供血血管立体解剖图像及残存肿瘤活性,对评估介入治疗的效果及治疗方案的选择具有重要指导意义。

The Application and Evaluation of Interventional Therapy for Hepatocellular Carcinoma(HCC) by 16-Section CT Angiography

Objective To study the clinical applied value of 16-Section CT angiography （CTA） and three dimensional reconstruction to guiding for interventional therapy, the treatment effect and cancer activity. Materials and Methods Sixty-five patients with HCC （seventeen Cpathologic diagnosis, forty-eight-clinical diagnosis） underwent MSCTA, im- age processing is performed using multiplanar reconstruction （MPR）, interactive maxi- mum-intensity-projection （MIP）, and volume-rendering techniques（VRT）.the relationship between the pattern of blood supply and lipiodol deposition situation or the tumor size was observed, to determine the treatment effect and choose the plan. Results Sixty-five patients with HCC underwent 186 MSCT, of which 9 cases were found anatomical abnor- mality of hepatic arteries, the extrahepatic artery were 55, 26 cases were the lacked reten- tion of lipiodol, the tumor obviously induced which was 38. significant negative associa- tivity occurrenced between lipiodol deposition situation, the tumor size and the extrahe- patic artery feeding in patients treated with transarterial chemoembolization （TACE） for hepatocellular carcinoma （HCC）. Conclusion MSCTA can intuitively and clearly demon- strate the anatomy image of the feeding arteries of the tumor ,which are of great value in the guidance and effect of treatment of Hepatocellular Carcinoma.