多层螺旋CT在肝癌经导管肝动脉化疗栓塞术疗效评估中的应用价值

目的探讨多层螺旋CT（MSCT）在肝癌经导管肝动脉化疗栓塞术（TACE）疗效分型、评估中的应用价值。方法收集2009年1月至2012年1月自愿到我院介入科接受TACE治疗的肝癌患者183例为研究组，全部病例均经临床和穿刺病理证实。TACE术前均行MSCT平扫和多期增强检查；TACE术后1个月，用MSCT进行平扫和多期增强扫描复查，观察TACE治疗后碘油沉积情况，并将治疗前后的MSCT图像进行对比，比较肿块的大小、血供及有无新生病灶。根据MSCT图像，对TACE治疗的疗效进行分型、评估。结果本组183例肝癌患者中，肿块型131例，结节型52例。131例肿块型中，疗效为完全缓解型（CR）37例；部分缓解型（PR）69例；暂时稳定型（TS）18例；进展型（PD）7例。52例结节型中，疗效为CR型40例；PR型9例；TS型3例。肿块型与结节型肝癌首次TACE治疗后，CR型疗效差异有统计学意义（P〈0．01）。二者治疗有效率差异无统计学意义（P〉0．05）。结论MSCT可用于肝癌TACE治疗后疗效的分型和评估，从而客观地评价患者TACE治疗的疗效及预后．并对下一步治疗有重要指导意义。

Application of multislice CT in therapeutic evaluation of transcatheter arterial chemoembolization for hepatocellular carcinoma

Objective To evaluate the clinical application value of muhislice CT（MSCT）in therapeutic classifing and evaluation of transcatheter arterial chemoembolization （TACE） for hepatocellular carcinoma. Methods One hundred and eighty-three patients with hepatocellular carcinoma which were confirmed by clinical and biopsy were collected for a study group ,All of which voluntarily accepted the treatment of TACE in our hospital. All of the pa- tients were examined by MSCT before and after TACE treatment. To observe the changes of tumor size , the blood supply and the iodine oil deposition within the tumor before and after TACE. To classify and evaluate the treatment effect of TACE according to the MSCT images. Results There were 131 massive hepatocarcinoma and 52 nodular hepatocarcinoma in this study group. There were 37 cases showed completely relieve type （CR）,69 showed part relieve type （PR）, 18 showed temporarily stable type（TS） and 7 showed progress disease type（PD） among the 131 mas- sive hepatocarcinoma after the first TACE. While 40 cases showed CR type, 9 showed PR type, 3 showde TS type among the 52 nodular hepatocarcinoma after the first TACE. The CR type differences of therapeutic efficacy between massive hepatocarcinoma and nodular hepatocarcinoma had very significant statistical significance （P〈0.01）. Condusion MSCT can be used for classifing and evaluation of treatment effect for liver cancer after TACE, so as to objectively evaluate the treatment effect and prognosis of the patients after TACE. And it has an important instruction meaning for the later treatment.