多层螺旋CT在肝细胞肝癌肝动脉化疗栓塞中的表现及介入治疗中的意义

目的探讨多层螺旋CT(MSCT)在肝细胞癌(HCC)肝动脉化疗栓塞中的表现特点及其介入治疗中的指导意义。方法45例肝癌患者行肝动脉化疗栓塞前同期分别行MSCT和DSA2种检查。MSCT应用三维容积再现(VRT)、最大密度投影(MIP)或多平面重组(MPR)技术观察腹腔动脉的解剖及走行分支,比较CT与DSA对病灶、合并症的显示情况及肿瘤的血供情况等。结果45例患者,MSCT发现病灶167个、门静脉癌栓11例、动脉静瘘12例;DSA发现病灶172个、门静脉癌栓8例,动静脉瘘15例。MSCT与DSA比较,DSA对肿瘤的数目显示率略高于MSCT,但差异无统计学意义。MSCT能够显示腹腔动脉及其主要分支的三维结构,优于DSA,观察与腹主动脉夹角较DSA更方便;MSCT发现肝动脉起源变异4例,与DSA完全符合。结论MSCT对肝细胞肝癌肝动脉化疗栓塞有重要指导意义。

Multislice Spiral CT Features and Its Significance of Hepatocellular Carcinoma in Interventional Therapy with Transcatheter Arterial Chemoembolization

Objective To study multislice spiral CT(MSCT) features and its significance of hepatocellular carcinoma(HCC) in interventional therapy with transcatheter arterial chemoembolization.Methods MSCT and DSA were performed in 54 cases of HCC before interventional procedure.The detection of lesions,complications and blood supply of tumors by CT and DSA were compared.The celiac artery branches were observed using the technique of VRT,MIP or MPR.Results 167 and 172 lesions,11 and 8 tumor thrombosis in portal vein,12 and 15 of hepatic arteriovenous fistula were showed by MSCT and DSA respectively.The positive rate of DSA in showing number of tumor lesions,tumor thrombosis in portal vein was slightly higher than that of MSCT,but there was no significant difference(P>0.05).CTA 3D reconstruction in showing celiac artery branches was better than that with DSA , the observation of angles between celiac artery and abdominal aorta with MSCT was more convenient than that with DSA.4 cases with hepatic artery original abnormality were detected by MSCT ,they were the same as DSA.Conclusion MSCT is of important value in guidance of transcatheter arterial chemoembolization of HCC.