肝癌肝动脉化疗栓塞术后血管改变及残癌的控制

目的:通过影像学检查动态监测肝动脉化疗栓塞术后(TACE)后肝癌残癌以研究其生物学特性与影像学表现,并通过综合介入治疗手段对其控制。方法:154例原发性肝癌患者接受TACE后每4周～8周行CT及血管造影检查以观察癌瘤的被控制状况,对残存癌瘤进行反复栓塞、灌注、无水酒精注射等介入处理。结果:肝癌TACE后的CT表现为瘤体内碘油填塞区,周边有规则的纤维包膜;残癌多发于瘤体的周边。DSA血管造影通过肿瘤血管和染色显示残癌的存在和生长状况。154例患者1a生存率为85.1%,2a生存率为37.1%,3a以上生存率为7.8%。结论:定期CT和DSA血管造影可以动态观察残癌的生长状况和评价TACE的效果,为进一步的控制治疗提供帮助。

The Co - relation between Hepatic Tumor Vessel Variations after TACE and The Monitor of Residues and Reoccurrences

Objective To study the co- relation between therapeutic efficacy of transcatheter arterial chemoembolization (TACE) and the variations of tumor vessels in malignant liver neoplasm after TACE, and to study the surveillance and control of the residual lesions. Methods 154 patients with malignant hepatic tumor were treated by TACE. CT scan, hepatic arterial angiography and indirect portal vein angiography were performed 4～8 months after TACE procedures. The therapeutic efficacies of TACE were evaluated according to the imaging findings and clinically follow up. Interventioual interference was performed at those cases with residual or recurrent tumors. Results Image of CT after TACE are accumulation of lipiodolin tumor and Capsulearound Tumour.Residual and recurrent lesions were found around tumors, which were proved by angiography findings of residual tumor vessels, embolized vessels, recanalization, tumor stain and tumor angiongenesis.In 154 patients, One-year survival rate were 85.1% and Two-year survival rate were 37.1% and Three-year survival rate 7.8%. Conclusion Tumor vessel recanalization and angiogenessi after TACE are directively relative to residual or recurrent tumor. Regularly CT scaning and Hepatic arterial angiography are helpful in monitoring residues and recurrences and evaluation in efficacy of TACE.