CT增强扫描和DSA检测原发性肝癌TACE术后肿瘤残留及新发病灶

目的对比研究CT增强扫描与DSA(数字减影血管造影)对原发性肝癌TACE(经导管肝动脉化疗栓塞术)术后肿瘤残留及新发病灶的检出效果。方法研究对象为我院收治的50例原发性肝癌患者,均行TACE治疗,术后半年内均行DSA和CT复查,比较两种影像学检查方法对肿瘤残留病灶和新发病灶的检出情况。结果 CT扫描显示密整型29例,缺损型12例,稀少型9例。CT增强扫描显示病灶动脉期无明显强化,共检出12枚新发病灶。经DAS检查发现,密整型患者中2例完全填充,呈类圆形高密度影,密度均匀、边界明确,肿瘤均无染色,27例可见边缘有缺损的类圆形病灶,密度不均,肿瘤染色明显,可见供血血管。缺损型患者透视下可见浅淡的、蜂窝状高密度影,血管迂曲,肿瘤在门静脉期呈浅淡染色。稀少型透视下有较为淡薄的染色。DSA检查发现36例患者的栓塞灶周围有血管增多、增粗表现,检出34枚新发病灶。CT扫描的肿瘤复发转移检出率为28.0%,DSA为72.0%,CT扫描的小病灶检出率为24.0%,DSA检查为68.0%。DSA的肿瘤复发转移检出率和小病灶检出率均明显高于CT扫查,P0.05。结论 CT增强扫描能较好地反映原发性肝癌TACE术后肿瘤内的碘化油沉积情况,DSA检查对小病灶的诊断特异性、敏感性更高。

Comparative Studies on CT Enhancement of Hepatocellular Carcinoma after TACE Tumor Residual and New Lesions of Primary Scanning and DSA Detection

Objective To study the enhanced CT scanning and DSA (DSA) on hepatocellular carcinoma TACE (transcatheter arterial chemoembolization) residual tumor after surgery and the detection effect of new lesions. Methods The research object for 50 cases in our hospital were primary hepatocellular carcinoma patients, all the patients were treated by TACE and within six months after the operation were performed DSA and CT Reexamination, the comparison of the two imaging methods of tumor residual lesions and lesion detection. Results CT scan showed dense integer 29 cases, 12 cases of defect type, 9 cases of rare type. CT scan showed no obvious enhancement in arterial phase, there were 12 new lesions. By Das examination found that dense integer in 2 cases completely filled, assumes the circular high density, uniform density, boundary clear, tumor showed no staining, 27 cases of visible edge defect of oval lesion, uneven density, tumor staining obvious, visible blood vessels. Defect patients X-ray visible pale, like high density shadow, vascular tortuosity, tumor in the portal venous phase was pale staining. There were relatively weak perspective rare type. DSA examination revealed enlarged vascular manifestations of 36 cases of patients with peripheral embolism were detected, 34 new lesions. Tumor recurrence CT scan metastasis detection rate was 28%, DSA was 72%, CT scan small lesion detection rate was 24%, DSA was 68%. DSA tumor recurrence and metastasis detection rate and detection rate of small lesions were significantly higher than that of CT scanning, P<0.05. Conclusion CT scan can reflect the primary lipiodol deposition within the tumor of hepatocellular carcinoma after TACE, digital subtraction angiography (DSA) for small lesion diagnosis specificity and sensitivity.