MSCT血管重建和雙重化療栓塞治療25例轉(zhuǎn)移性肝癌

【關(guān)鍵詞】 肝腫瘤

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血管重建和雙重化療栓塞治療轉(zhuǎn)移性肝癌的效果. 方法： 選擇轉(zhuǎn)移性肝癌患者25(男18，女7)例，隨機(jī)分為2組，采用16層螺旋CT對(duì)肝動(dòng)脈、門靜脈進(jìn)行血管重建；11例DSA下單獨(dú)給予肝動(dòng)脈化療栓塞（TACE）治療（對(duì)照組），14例彩超引導(dǎo)下給予門靜脈穿刺化療栓塞（PVE）（治療組），1 wk后于DSA下肝動(dòng)脈化療栓塞治療，觀察和比較兩組治療前后患者瘤體體積、白細(xì)胞和肝功能、生活質(zhì)量變化. 結(jié)果： MSCT肝動(dòng)脈、門靜脈血管重建成功率均為100%，可清楚顯示ⅣⅤ級(jí)肝臟血管，發(fā)現(xiàn)門靜脈包繞腫瘤，周邊以雙重血供為主，隨著腫塊的增大，中間壞死灶無明顯血供，肝動(dòng)脈DSA造影提示60%轉(zhuǎn)移瘤以肝動(dòng)脈血供為主，結(jié)合彩超引導(dǎo)下介入栓塞治療，40%門靜脈除包繞腫瘤組織外，還有細(xì)小分支插入腫瘤內(nèi)部，以門靜脈血供為主；兩組治療前后瘤體體積、白細(xì)胞和肝功能變化、生活質(zhì)量無顯著差異（P

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