MSCT血管重建及双重化疗栓塞治疗25例转移性肝癌.docVIP

MSCT血管重建及双重化疗栓塞治疗25例转移性肝癌 　 作者：陈雄，彭永海，欧阳学农，李天然 【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. The white blood cell level, hepatic function, tumor size and life quality were observed before and after treatment. RESULTS: All the hepatic arteries and portal veins were successfully restructured and ⅣⅤgrade hepatic blood vessels were seen clearly in images from DSA and colorultrasonic imaging. We found that in 60% cases, hepatic artery was the main vessel supplying blood to tumors while in 40% cases, tumors were surrounded by portal veins and the blood were supplied by portal veins. In large tumors, the center part was necrotic and had no blood supply. No significant differences were found in the size of tumors or in the levels of WBC, TBIL, ALT and life quality between control and treatment groups（Pgt;0.05）. CONCLUSION: Vascular restructure with MSCT and chemoembolization through portal vein and liver artery, with no obvious sideeffects, are effective for patients with liver cancer metastases. 　　【Keywords】 metastasis; hepatic neoplasm; MSCT; TACE; PVE 　　【摘要】 目的： 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