CT/MR强化扫描指导肝癌肝动脉化疗栓塞后重复治疗时间选择的研究

目的 :研究肝癌患者在行经肝动脉化疗栓塞 (TACE)后 ,利用CT和 /或MR强化扫描确认再次TACE治疗的时间。方法 :通过对肝癌患者行TACE后定期CT和 /或MR强化扫描复查 ,观察瘤灶内碘化油的沉积以及肿瘤组织的强化情况 ,根据这些情况判断该患者是否需要再次行TACE治疗 ,选择再次TACE治疗的最佳时间。结果 :10 6例肝癌患者行TACE后定期CT强化扫描复查 ,扫描示肿瘤内碘化油沉积密实 ,呈团块状 ,无缺损 ,瘤灶较前缩小 ,无新病灶供血者 36例 (占 34% ) ,近期不行TACE ,结合AFP检验适当延长再次TACE时间 ,间隔 1月左右复查CT和 /或MR检查 ,根据CT和 /或MR检查情况来判断是否需要再行TACE ;瘤灶内碘化油大部分密实或仅有少量斑点状、片状碘化油积聚者 70例 (占 6 6 % ) ,在CT和 /或MR扫描后及早再次行TACE治疗 ,并于 1个月左右复查CT和 /或MR。对于瘤灶体积稳定 ,无明显增大 ,结合AFP化验不升高甚至下降者可酌情延长CT和 /或MR复查时间 ,反之则需定期复查。结论 :根据CT和 /或MR扫描结果可指导选择再次TACE的时间 ,减少不必要的治疗次数 ,减轻病人的痛苦和经济负担 ,减少治疗的并发症 ,提高病人的生存质量。TACE后定期CT和 /或MR强化扫描对指导选择再次TACE治疗的时间有重要的临床意义。

The study on schedule for second treatment after transhepatic arterial chemotherapeutic embolism with contrast CT/MR

Objective:To study the time for the next treatment of transhepatic arterial chemotherapeutic embolism (TACE) after the first treatment by contrast CT and/or MR scanning. Methods: The 106 patients with liver cancer were checked by contrast CT and/or MR to observe the deposit of iodine oil in tumor and intensification of cancer tissue after TACE. Judgment was made if the next treatment of TACE was needed and the best time was selected for the next treatment.Results:106 cases of patients with liver cancer after TACE are reexamined by contrast CT and/or MR. According the different appearance of CT and/or MR images, the next treatment of TACE was decided if it is needed or not. Conclusion:Opportunity for second TACE has been chosen according to CT and/or MR appearance. It could alleviate the patients’ suffering, reduce the complication of treatment and improve the patients’ living quality. The contrast CT and/or MR after TACE was significant importance in guiding the choice of opportunity for second TACE.