MSCT血管重建和双重化疗栓塞治疗25例转移性肝癌

【关键词】 肝肿瘤

MSCT vascular reconstruction and double chemoembolization through portal vein and liver artery in 25 patients with liver cancer metastases

　　【Abstract】 AIM: To study the effect of MSCT vascular reconstruction and chemoembolization through portal vein and liver artery in patients with liver cancer metastases. METHODS: Twentyfive patients (male 18, female 7) with liver cancer metastases were randomized into 2 groups. In all these patients, the hepatic vessels were restructured with MSCT while 11 patients in control group received only transcatheter arterial chemoembolization (TACE) therapy and 14 patients received TACE 1 week after portal vein chemoembolization in the treatment group. TACE was steered by digital Xray and percutaneous iodized oil portal vein injection was steered by colorultrasonic imaging. 研究MSCT血管重建和双重化疗栓塞治疗转移性肝癌的效果. 方法： 选择转移性肝癌患者25(男18，女7)例，随机分为2组，采用16层螺旋CT对肝动脉、门静脉进行血管重建；11例DSA下单独给予肝动脉化疗栓塞（TACE）治疗（对照组），14例彩超引导下给予门静脉穿刺化疗栓塞（PVE）（治疗组），1 wk后于DSA下肝动脉化疗栓塞治疗，观察和比较两组治疗前后患者瘤体体积、白细胞和肝功能、生活质量变化. 结果： MSCT肝动脉、门静脉血管重建成功率均为100%，可清楚显示ⅣⅤ级肝脏血管，发现门静脉包绕肿瘤，周边以双重血供为主，随着肿块的增大，中间坏死灶无明显血供，肝动脉DSA造影提示60%转移瘤以肝动脉血供为主，结合彩超引导下介入栓塞治疗，40%门静脉除包绕肿瘤组织外，还有细小分支插入肿瘤内部，以门静脉血供为主；两组治疗前后瘤体体积、白细胞和肝功能变化、生活质量无显著差异（P