螺旋CT肝动脉期肝癌强化形态及血供与介入栓塞治疗后碘油聚集形态及量的关系

目的探讨螺旋CT肝动脉期原发性肝癌强化形态及血供与经肝动脉插管栓塞治疗后碘油聚集形态及量的关系。方法回顾性对32例螺旋CT肝动脉期原发性肝癌强化形态及血供表现与其栓塞治疗后肿瘤内碘油分布情况进行对比分析。结果32例肝癌栓塞治疗后肿瘤内碘油分布分为5种类型:均匀致密型(11例)、不均匀致密型(7例)、稀疏型(5例)、缺损型(3例)及混合型(3例)。肝动脉期肝癌肿瘤组织明显强化、或多量强化肿瘤血管影,栓塞后肿瘤内碘油多为均匀致密型或不均匀致密型。肝动脉期肝癌肿瘤组织无或轻度强化、或少量、稀散、僵硬强化肿瘤血管,栓塞后肿瘤内碘油分多为稀疏型、缺损型或混合型。肝动脉期肿瘤内多血供明显强化区,碘油聚集量多。无或轻度强化少血供区,碘油聚集量多较少或无碘油聚集。结论螺旋CT肝动期原发性肝癌强化血管形态及血供对预测其碘油栓塞治疗术后聚集形态及聚集量有重要价值。

Hepatocellular carcinoma: the correlation between the enhancement in arterial- phase and lipiodol accumulation after the trans - arterial chemoembotherapy

Objective To investigate the relationship between enhancement in arterial- phase, indicating arterial blood supply of the lesions of hepatocellular carcinoma and lipiodol accumulation after the trans- arterial chemoembotherapy. Methods CT images of primary hepatocellular carcinoma in 32 cases during the hepatic arterial- phase were retrospectively compared with the CT images of lipiodol distribution within the tumor after the trans- arterial chemoembotherapy. Results The lipiodol distribution was classified into five types: homogeneous and compact( n=11) , inhomogeneous though compact( n=7) , scanty( n=5) , poorly filled( n=3) and miscellaneous( n=3) . The lipiodol has a homogeneous or inhomogeneous but compact distribution when remarkable enhancement of the tumor or dominant neoplastic vascularity was demonstrated during hepatic arterial- phase. The lipiodol distribution was scanty, poorly filled, or miscellaneous distributed in the nidus of the hepatocellular carcinoma with no or poor enhancement, or with hypo- vascularity during hepatic arterial- phase. Where there was abundant vascularity of the tumor, there would be a satisfying accumulation of the lipiodol. Conclusion The CT assessmant of the arterial- phase vascularity of the hepatocellular provides valuable information of lipiodol accumulation after the trans- arterial chemoembotherapy.