CAJ | 학술논문

目的：探讨原发性肝细胞癌(HCC)经介入治疗后肿瘤存活区的CT表现及血供情况，旨在为介入治疗后选择再治疗方案提供一定的指导。方法240例HCC患者共计288个病灶，经肝动脉灌注碘化油栓塞术(LP-TACE)介入治疗后均行MSCT平扫及双期增强扫描，根据双期增强扫描不同时期的强化表现，统计各血供类型所占的比例，并对比介入治疗前后肿瘤血供情况。结果①经介入治疗后的肿瘤存活区的CT平扫表现为：肿瘤内均可见不同形状及程度的碘化油沉积，存活区均为低密度，CT值为(37.29±5.40)Hu；②肿瘤存活区肝动脉供血型119例(49.58%)、门静脉供血型9例(3.75%)、双重供血型101例(42.08%)及少血供型11例(4.58%)；③介入治疗后门静脉供血型例数19例、肝动脉供血型199例、少血型22例，门静脉供血比例为8.72%(19/218)；介入治疗后门静脉供血型例数115例、肝动脉供血型120例、少血型5例，门静脉供血比例为48.94%(115/235)，治疗后门静脉供血比例显著大于治疗前(P＜0.05)。结论经介入治疗后HCC存活区血供类型以肝动脉供血型及肝动脉、门静脉双重供血型为主，而单纯门静脉及少血供类型较少；介入治疗后门静脉对肿瘤存活区的供血显著增加，从而为介入治疗后采取再治疗的方案提供一定的指导价值。
목적：탐토원발성간세포암(HCC)경개입치료후종류존활구적CT표현급혈공정황，지재위개입치료후선택재치료방안제공일정적지도。방법240례HCC환자공계288개병조，경간동맥관주전화유전새술(LP-TACE)개입치료후균행MSCT평소급쌍기증강소묘，근거쌍기증강소묘불동시기적강화표현，통계각혈공류형소점적비례，병대비개입치료전후종류혈공정황。결과①경개입치료후적종류존활구적CT평소표현위：종류내균가견불동형상급정도적전화유침적，존활구균위저밀도，CT치위(37.29±5.40)Hu；②종류존활구간동맥공혈형119례(49.58%)、문정맥공혈형9례(3.75%)、쌍중공혈형101례(42.08%)급소혈공형11례(4.58%)；③개입치료후문정맥공혈형례수19례、간동맥공혈형199례、소혈형22례，문정맥공혈비례위8.72%(19/218)；개입치료후문정맥공혈형례수115례、간동맥공혈형120례、소혈형5례，문정맥공혈비례위48.94%(115/235)，치료후문정맥공혈비례현저대우치료전(P＜0.05)。결론경개입치료후HCC존활구혈공류형이간동맥공혈형급간동맥、문정맥쌍중공혈형위주，이단순문정맥급소혈공류형교소；개입치료후문정맥대종류존활구적공혈현저증가，종이위개입치료후채취재치료적방안제공일정적지도개치。
Objective To analyze the CT performance and blood supply of tumor survival area of primary hepatocellular carcinoma (HCC) which were treated by interventional therapy, in order to provide guidance for the selection of the second treatment. Methods 240 cases of HCC patients with a total of 288 lesions, performed MSCT plain and dual phase enhanced scanning after lipiodol embolization by hepatic artery infusion (LP-TACE). Count the proportion of the blood supply type according to the dual phase enhanced scanning in different periods of performance enhancement, and compared before and after interventional therapy of tumor blood supply. Results① The performance of interventional treatment of viable tumor CT plain area: the interior tumor were lipiodol deposit visible shape and degree of different, survival areas were low density, and its CT value was (37.29 ± 5.40) Hu; ② The hepatic artery blood supply of viable tumor area was 119 cases (49.58%), portal vein blood supply types was 9 cases (3.75%), double blood supply types was 101 cases(42.08%) and less blood supply was 11 cases (4.58%);③ a number of 19 cases, 199 cases of hepatic artery blood supply types, less blood in 22 cases and interventional treatment of portal vein blood supply type cases, the proportion of portal vein blood was 8.72% (19/218); interventional therapy for portal vein blood group were 115 cases, 120 cases of hepatic artery blood supply types, less blood type in 5 cases, portal vein supply ratio of 48.94%(115/235), treatment of portal vein blood was significantly greater than before treatment (P<0.05). Conclusion The blood supply types of HCC which after the Interventional treatment is mainly to hepatic artery blood supply and the combination of hepatic artery and portal blood supply. The blood supply from portal vein increased after the interventional treatment ,which provided some guidance value to the treatment scheme.