不同影像检查手段探查原发性肝癌TACE术后肿瘤残留及新发病灶临床价值对比.docVIP

不同影像检查手段探查原发性肝癌TACE术后肿瘤残留及新发病灶的临床价值对比 　　[摘要] 目的 探讨不同影像检查手段探查原发性肝癌经导管肝动脉化疗栓塞（transcatheter arterial chemoembolization，TACE）术后肿瘤残留及新发病灶的临床价值。 方法 选取2015年9月～2017年3月我院肿瘤科收治的79例原发性肝癌患者为研究对象，在患者TACE术后的1～6个月内行数字减影血管造影（digital subtraction angiography，DSA）、电子计算机断层扫描（computed tomography，CT）、核磁共振成像（magnetic resonance imaging，MRI）和超声造影检查，以DSA造影检查为标准，比较CT、MRI和超声的检测结果。 结果 对于病灶≤5 cm和病灶包膜的探查，MRI检测的结果优于CT和超声造影，在门静脉内癌栓探查方面，CT检测的准确性高于MRI和超声造影，在病灶强化探查方面，MRI和超声造影的特异度高于CT，以上结果差异均有统计学意义（P0.05）。 结论 MRI扫描在探查原发性肝癌TACE术后肿瘤残留及新发病灶的临床价值较高，值得??先考虑。 　　[关键词] 原发性肝癌；TACE术；DSA；CT；MRI；超声造影 　　[中图分类号] R445；R735.7 [文献标识码] B [文章编号] 1673-9701（2018）07-0111-04 　　[Abstract] Objective To investigate the clinical value of different imaging methods in detecting tumor residual and new lesions after transcatheter arterial chemoembolization（TACE） in primary hepatocellular carcinoma. Methods From September 2015 to March 2017， 79 patients with primary hepatocellular carcinoma admitted to our hospital were treated with TACE. Digital subtraction angiography（DSA）， CT， magnetic resonance imaging（MRI） and contrast-enhanced ultrasonography were performed within 1-6 months after TACE. DSA angiography as the standard comparison of CT， MRI and ultrasound test results. Results For the detection of ≤5 cm and lesions， the results of MRI were superior to those of CT and contrast-enhanced ultrasound， and in the detection of tumor thrombus in portal vein， the accuracy of CT was higher than that of MRI and contrast-enhanced ultrasound， and in the enhanced focus of the investigation， MRI and contrast-enhanced ultrasound were higher than those of CT， the differences were statistically significant（P0.05）. Conclusion The clinical value of MRI scanning in the detection of tumor residue and new foci after tace for primary hepatocellular carcinoma is worthy of high priority. 　　[Key words] Primary liver cancer； TACE； DSA； CT； MRI； Ultrasonography 　　原发性肝癌是指发生于肝细胞或是肝内胆管细胞的恶性肿瘤，具有恶性程度高、进展快、起病隐匿且发病年龄低等特点，在我国原发性肝癌的病死率中居恶性肿瘤的第二位[1，2]，居世界肿瘤相