明胶海绵微粒化疗栓塞结直肠癌肝转移疗效的影像学评价.pdf

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1、临床放射学杂志2014年第33卷第2期·267·介入治疗明胶海绵微粒化疗栓塞结直肠癌肝转移疗效的影像学评价李闯，张跃伟，赵旭，赵广生，周军，唐顺雄，刘影【摘要】目的探讨多层螺旋cT评价明胶海绵微粒化疗栓塞治疗结直肠癌根治术后肝转移患者的临床疗效的影像学特点。方法回顾性分析31例自2009年12月至2011年12月在我院应用明胶海绵微粒化疗栓塞治疗结直肠癌根治术后肝转移患者的临床资料，评价明胶海绵微粒化疗栓塞前后的多层螺旋CT影像学表现。结果患者术后4天即可见病灶内多个大小不等泡状气体密度影，呈“蜂窝”状改变，术后1个月及3个月复查CT病灶平扫期表现呈类圆形不均匀混杂低密度影，内见散在泡状气体

2、影；增强扫描动脉期病灶内可见低密度无强化坏死区；31例行经肝动脉化疗栓塞术后病灶均有不同程度坏死，完全缓解者(CR)：2例；部分缓解(PR)：23例；稳定(SD)：6例；总有效率(CR+PR)为80％。结论明胶海绵微粒化疗栓塞治疗结直肠癌根治术后肝转移取得良好的近期疗效，多层螺旋CT能准确地判断病灶坏死及残留病灶和新病变的治疗效果，指导再次治疗。【关键词】结直肠癌肝转移明胶海绵微粒肝动脉化疗栓塞多层螺旋cTImagingFeaturesandEficacyofGelatinSpongeParticlesChemoembolizationforColorectalCancerLiverMeta

3、stasesLIChuang，ZhangYuewei，ZHAOXu，eta1．DepartmentofInterventional，ZhongshanHospitalofDalianUniversity，Dalian，LiaoningProvince161000，P．R．China【Abstract】ObjectiveToevaluatetheCTimagingandefficacyofgelatinspongeparticleschemoembolizationintreat-meritofcolorectalcancerlivermetastasis．Methods31caseswith

4、colorectalcancerlivermetastasisunderwentgelatinspongeparticleschemoembolizationfromDecember2009toDecember2011inourhospita1．ThepatientsperformedCTex‘aminationbeforeandafterchemoembolization．TheclinicaldataandCTfeatureswereretrospectivelyanalyzed．ResultsAt4daysafterchemoembolization．thelesionsshowedg

5、asdensityinsidetumorswithhoneycombchangeonplainCTima—ges．Atlmonthandthreemonthsafterchemoembolization，thelesionsshowedheterogeneouslowdensityandscatteredgasonpalinCTimages．ThelesionsshowednoenhancementoncontrastCTimages．31lesionsshowedvaryingdegreesofnec—rosisafterTACE，completeremission(CR)in2cases

6、，partialremission(PR)in23Cases，stable(SD)in6casesandtotaleffectiverate(CR+PR)was80％．ConclusionGelatinspongeparticleschemoembolizationhasgoodshorttermeffectintreatmentofcolorectalcancerlivermetastasis．MultislicespiralCTcanevaluatenecrosis，determinethetherapeuticeffectofresiduallesionsandlesionreeurr

7、eneaccurately．【Keywords】ColorectallivermetastasesGelatinspongeparticlesHepaticarterialchemoembolizationMuhilayerspi—ralCT作者单位：161000辽宁省大连市，大连大学附属中山医院介入科；通讯作者12齐丽萍，陈颖，高顺禹，等．cT肺动脉造影检测肺栓塞：采用容积CTradiationdosewi