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目的探讨经导管肝动脉化疗栓塞术(TACE)治疗肝癌后继发肝实质损伤的发生机制及CT表现。方法对146例患者做TACE589次,观察TACE术后肝实质损伤的发生机制及CT表现。结果胆管损伤5例,表现为碘油沉积区边缘低或水样密度影;动静脉瘘7例,病灶周围肝实质呈不规则形或楔形提早强化区;肝实质萎缩27例,表现为胆管损伤区肝叶-段呈进行性萎缩。结论熟悉TACE术引起肝实质损害的机制及CT表现有重要临床意义,对确定治疗效果及识别肿瘤复发或新生病灶有重要参考价值。
Objective To investigate the mechanism and CT appearance of secondary hepatic parenchymal injury after transcatheter hepatic arterial chemoembolization (TACE). Methods A total of 146 patients underwent TACE 589 times to observe the mechanism of liver parenchymal injury after TACE and CT findings. Results In 5 cases of bile duct injury, there were low edge or density of water samples in the lipiod deposition area. Seven cases of arteriovenous fistula showed irregular hepatic parenchyma or early wedge-shaped enhancement area. 27 cases of hepatic parenchymal atrophy showed bile duct injury District liver - segment was progressive atrophy. Conclusion It is of great clinical significance to know the mechanism of hepatic parenchymal damage caused by TACE and the CT manifestations. It is of important value in determining the therapeutic effect and identifying the tumor recurrence or neoplasia.