[1]黄郭灏,任建庄,段旭华,等.C臂CT引导经皮乙醇消融术在巨块型肝癌经肝动脉化疗栓塞后的近期疗效[J].介入放射学杂志,2015,(01):41-45.
 HUANG Guo hao,REN Jian zhuang,DUAN Xu hua,et al.The short term efficacy of C arm CT guided percutaneous ethanol ablation for massive hepatocellular carcinoma after transcatheter arterial chemoembolization treatment[J].journal interventional radiology,2015,(01):41-45.
点击复制

C臂CT引导经皮乙醇消融术在巨块型肝癌经肝动脉化疗栓塞后的近期疗效 ()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2015年01期
页码:
41-45
栏目:
肿瘤介入
出版日期:
2015-01-25

文章信息/Info

Title:
The short term efficacy of C arm CT guided percutaneous ethanol ablation for massive hepatocellular carcinoma after transcatheter arterial chemoembolization treatment
作者:
黄郭灏 任建庄 段旭华 张 凯 张萌帆
Author(s):
HUANG Guo hao REN Jian zhuang DUAN Xu hua ZHANG Kai ZHANG Meng fan.
Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China
关键词:
【关键词】 C臂CT 巨块型肝癌 经皮无水乙醇消融术 肝动脉化疗栓塞术
文献标志码:
A
摘要:
【摘要】 目的 评价C臂CT引导经皮无水乙醇消融术(PEI)在巨块型肝癌经肝动脉化疗栓塞术(TACE)后的可行性及近期疗效。方法 回顾分析巨块型肝癌患者95例,其中40例行单纯TACE治疗(对照组),55例行TACE联合PEI治疗(联合组)。对照组1个月后重复TACE治疗1次。联合组TACE 1周后行PEI。术前经C臂CT扫描评估碘油沉积情况,定位穿刺路径及注入部位。2周后对碘油沉积缺损部分追加PEI。3个月后两组复查CT,对碘油沉积分布情况进行统计学分析。结果 联合组初次PEI术后显示碘油沉积为Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为41.8%(23/55)、49.1%(27/55)、7.3%(4/55)和1.8%(1/55);2周后分别为25.4%(14/55)、50.9%(28/55)、16.4%(9/55)和7.3%(4/55)。再次对除Ⅰ型病灶外的41例患者行PEI。3个月后复查CT,对照组碘油沉积Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为7.5%(3/40)、30%(12/40)、42.5%(17/40)、20%(8/40);联合组碘油沉积Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为30.9%(17/55)、40%(22/55)、23.6%(13/55)、5.5%(3/55)。两组差异有统计学意义。结论 C臂CT成像技术在TACE术后联合PEI治疗巨块型肝癌的指导和评估中具有重要价值,保证了手术的安全性、准确性和有效性。

参考文献/References:

[1] Sakr AA, Saleh AA, Moeaty AA, et al. The combined effect of radiofrequency and ethanol ablation in the management of large hepatocellular carcinoma[J]. Eur J Radiol, 2005, 54: 418 425.
[2] 徐 克, 于世平. 原发性肝癌的肝动脉化疗栓塞治疗[J]. 中国实用外科杂志, 2004, 24: 463 465.
[3] 李兴睿, 杨志芳, 易继林. 肝癌经肝动脉栓塞化疗后VEGF和CD44v6表达的意义[J]. 世界华人消化杂志, 2006, 14: 1305 1308.
[4] 徐 霖, 杨守俊, 陈平有, 等. DSA类CT成像技术在经皮穿刺椎体成形术中的临床应用[J]. 放射学实践, 2009, 24: 1254 1257.
[5] Matsuo N, Uchida H, Sakaguchi H, et al. Optimal lipiodol volume in transcatheter arterial chemoembolotherapy for hepatocellular carcinoma: study based on lipiodol accumulation patterns and histopathologic findings[J]. Semin Oncol, 1997, 24: S6 61.
[6] Llovet JM, Bruix J. Novel advancements in the management of hepatocellular carcinoma in 2008[J]. J Hepatol, 2008, 48: S20 S37.
[7] 吴汉平, 冯敢生, 李 欣, 等. 血管内皮生长因子反义寡聚脱氧核苷酸与碘油混合栓塞治疗大鼠肝癌的实验研究[J]. 中华放射学杂志, 2003, 37: 1062 1067.
[8] 鲁 东, 吕维富, 王伟昱, 等. 肝癌动脉血供变异在介入治疗中的意义[J]. 医学影像学杂志, 2007, 17: 700 703.
[9] 徐 辉, 王 滨, 高志芹, 等. 肝动脉化疗栓塞对肝癌肿瘤新生血管生成的影响[J]. 实用放射学杂志, 2004, 20: 620 622.
[10]黄满平, 古善智, 李国文, 等. 探讨化学消融在肝周转移瘤治疗中的价值[J]. 介入放射学杂志, 2012, 21: 232 234.
[11] Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. conclusions of the barcelona 2000 EASL conference[J]. J Hepatol, 2001, 35: 421 430.
[12] Bruix J, Llovet JM. Prognostic prediction and treatment strategy in hepatocellular carcinoma[J]. Hepatology, 2002, 35: 519 524.
[13] Livraghi T, Benedini V, Lazzaroni S, et al. Long term results of single session percutaneous ethanol injection in patients with large hepatocellular carcinoma[J]. Cancer, 1998, 83: 48 57.
[14] 肖运平, 刘惕生, 许 彪, 等. C臂CT在腹部介入诊疗中的初步应用[J]. 介入放射学杂志, 2011, 20: 410 413.
[15] 翟凤杰. 血管造影三维软组织成像技术(DynaCT)[J]. 中国医疗器械信息, 2007, 13: 41 42, 75.
[16] Baba R, Konno Y, Ueda K, et al. Comparison of flat panel detector and image intensifier detector for cone beam CT[J]. Comput Med Imaging Graph, 2002, 26: 153 158.
[17] 施惠斌, 王建华, 冯 豪, 等. 腹部DynaCT断层及Inspace 3D重建图像在肝肿瘤介入治疗中的应用价值[J]. 中国介入影像与治疗学, 2007, 4: 396 399.
[18] Wallace MJ, Kuo MD, Glaiberman C, et al. Three dimensional C arm cone beam CT: applications in the interventional suite[J]. J Vasc Interv Radiol, 2008, 19: 799 813.
[19] 包乐群, 徐 虎. TACE联合PEIT治疗转移性肝癌[J]. 肿瘤防治研究, 2009, 36: 775 777.
[20] Gattoni F, Dova S, Tonolini M, et al. Study of the liver and the portal venous system with digital rotational angiography[J]. Radiol Med, 2001, 101: 118 124.
[21]姜秀杰, 胡元清, 赵立峰, 等. 经皮肝瘤内注入无水乙醇结合TACE治疗中晚期原发性肝癌的疗效观察[J]. 当代医学: 中国介入放射学, 2008, 2: 55 57.
[22] 施振静, 虞希祥, 郝伟远, 等. C臂CT在肝癌TACE术中评估碘油沉积的应用价值[J]. 介入放射学杂志, 2013, 22: 301 304.
[23] Nakayama A, Imamura H, Matsuyama Y, et al. Value of lipiodol computed tomography and digital subtraction angiography in the era of helical biphasic computed tomography as preoperative assessment of hepatocellular carcinoma[J]. Ann Surg, 2001, 234: 56 62.
[24] Takayasu K, Arii S, Matsuo N, et al. Comparison of CT findings with resected specimens after chemoembolization with iodized oil for hepatocellular carcinoma[J]. AJR, 2000, 175: 699 704.

相似文献/References:

[1]吴纪瑞,杨永岩,杨熙章,等.丝裂霉素C微囊肝动脉化疗栓塞术治疗中晚期肝癌[J].介入放射学杂志,1992,(01):41.
[2]高 嵩,朱 旭,张宏志,等.经皮椎体后凸成形术治疗椎体转移瘤中C臂CT的临床应用[J].介入放射学杂志,2014,(02):167.
 GAO Song,ZHU Xu,ZHANG Hong? zhi,et al. Clinical application of C?蛳 arm CT in percutaneous kyphoplasty due to vertebral metastases[J].journal interventional radiology,2014,(01):167.
[3]廖新彬,李明菊. 肝动脉化疗栓塞和经皮乙酸消融治疗巨块型肝癌的围手术期护理[J].介入放射学杂志,2012,(10):873.
 LIAO Xin- bin,LI Ming- ju..Perioperative nursing care for patients receiving hepatic artery chemoembolization together with percutaneous acetic acid ablation for massive hepatocarcinomas[J].journal interventional radiology,2012,(01):873.
[4]黄大钡,李晓群,张 健,等.C臂CT在肺小结节胸腔镜切除术前定位中的应用[J].介入放射学杂志,2017,(09):843.
 HUANG Dabei,LI Xiaoqun,ZHANG Jian,et al.The application of C- arm CT in guiding preoperative hook- wire localization of solitary pulmonary nodule before thoracoscopic resection[J].journal interventional radiology,2017,(01):843.
[5]邹旭公,李晓群,陈 源,等.C臂CT引导经皮穿刺射频消融治疗不可切除Ⅰa期非小细胞肺癌 [J].介入放射学杂志,2018,27(11):1056.
 ZOU Xugong,LI Xiaoqun,CHEN Yuan,et al.C- arm CT- guided percutaneous radiofrequency ablation for unresectable stage Ⅰa non- small cell lung cancer[J].journal interventional radiology,2018,27(01):1056.
[6]林志鹏,邹旭公,黄大钡,等.C臂CT引导下经皮椎体成形术治疗颈1椎体转移瘤1例 [J].介入放射学杂志,2023,32(04):393.
 LIN Zhipeng,ZOU Xugong,HUANG Dabei,et al.C-arm CT-guided percutaneous vertebroplasty for the treatment of atlas metastases: report of one case[J].journal interventional radiology,2023,32(01):393.
[7]卢世涛,毛鑫宇,杨凯仑,等.C臂CT栓塞导航判断肾出血责任血管1例[J].介入放射学杂志,2023,32(12):1268.
 LU Shitao,MAO Xinyu,YANG Kailun,et al.Application of C-arm CT navigation technique in determining the responsible artery during the embolization therapy of renal hemorrhage: report of one case[J].journal interventional radiology,2023,32(01):1268.

备注/Memo

备注/Memo:
(收稿日期:2014-03-18)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2015-01-26