【摘要】 目的:探讨原发性肝癌肝动脉灌注栓塞后非坏死低密度区血供的多层螺旋CT分型,以期对再治疗方案和途径的选择提供有价值的信息。方法:利用多层螺旋CT对57例行肝动脉灌注栓塞后的肝癌患者行肝脏平扫及增强双期扫描,根据增强扫描不同时期的强化表现,将非坏死低密度区的血液供应分成四型:双重供血型、少血供型、肝动脉供血型、门静脉供血型;将供血比例进行合理的统计,并和手术之前的肿瘤血供进行比较。结论:57个肝癌病人的肝动脉灌注栓塞后非坏死低密度区血供表现为:22个双重供血型、4个少血供型、29个肝动脉供血型、2个门静脉供血型。与术前肿瘤血供比较,门静脉参与供血有所增加。结论:多层螺旋CT增强双期扫描对肝癌肝动脉灌注栓塞以后肿瘤内非坏死低密度区的血供有重要的诊断价值,对继续治疗方案的选择与制定有一定的临床意义。更多还原

【Abstract】 Objective:To assess the value of dual-phase multidetector-row computed tomography(MDCT) in choosing retreatment methods of hepatocellular carcinoma(HCC) through evaluating the blood supply of low-density are(aLDA) of HCC after transcatheter arterial chemoembolization using lipiodol(LP-TACE).Methods:Fifty-seven patients with HCC after LP-TACE treatment were examined by plain scanning and hepatic dual-phase MDCT.The performance of LDA on plain scanning and the enhancement patterns on dynamic contrast-enhanced scanning were observed.The blood supply of LDA was classified into four types:arterial blood supply,portal blood supply,arterial combining with portal blood supply and poor blood supply.At the same time,the attribution of portal venous blood supply to LDA was compared with that before LPTACE.Results:In contrast-enhanced CT scans,the blood supply of LDA was classified into four types:arterial blood supply(29 cases),portal blood supply(2 cases),arterial combining with portal blood supply(22 cases) and poor blood supply(4 cases).The attribution of portal venous blood supply to LDA was significantly increased after LP-TACE..Conclusion:Hepatic dual-phase MDCT is an effective method in evaluating the blood supply of LDA and the therapeutic effect of HCC after LP-TACE treatment.?Types of blood supply give us the selection of retreatment.更多还原