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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。
OBJECTIVE: To dynamically monitor the residual carcinoma of liver cancer after TACE by means of imaging examination to study its biological characteristics and imaging features and to control it through comprehensive interventional therapy. Methods: 154 cases of primary liver cancer patients underwent TACE every 4 weeks to 8 weeks underwent CT and angiography to observe the status of cancer control, the residual cancer re-embolization, perfusion, ethanol injection and other interventions . Results: The CT manifestations of TCC in liver cancer were the lipiodol stuffing area in the tumor with regular fibrous capsule around. The residual cancer was frequently found in the periphery of the tumor. DSA angiography shows the presence and growth of residual cancer by tumor blood vessels and staining. 154 patients with 1a survival rate was 85.1%, 2a survival rate was 37.1%, 3a survival rate was 7.8%. Conclusions: Regular CT and DSA angiography can dynamically observe the growth status of residual cancer and evaluate the effect of TACE, so as to help further control the treatment.