论文部分内容阅读
目的研究64排螺旋CT三维重建影像技术在肝癌外科中的临床应用价值。方法对2005年11月至2006年7月,南方医科大学珠江医院行64排螺旋CT三维成像检查34例原发性肝癌临床资料进行总结,并与术中探查结果、手术方式及介入治疗进行对照评价。结果34例原发性肝癌病人64排螺旋CT三维重建成像显示:癌肿肿瘤未侵犯邻近组织、血管者23例,肿瘤压迫邻近血管者9例,动静脉瘘1例,门静脉癌栓1例。3例病人行TACE(经导管肝动脉化疗栓塞术)治疗,其余31例均行手术治疗,与术中探查结果相一致者30例,正确率96.7%。行根治性切除12例,右半肝切除8例,左外叶切除5例,左半肝切除2例,左半肝切除加门静脉癌栓取栓1例,左三叶切除1例,右三叶切除1例,尾状叶切除1例。结论64排螺旋CT三维成像检查可以很好地显示肿瘤的界限、累及范围,特别能精确判断肿瘤与肝脏血管的关系,充分了解肝脏血管变异情况,其结果对病变程度估计及指导外科治疗抉择有重要价值。
Objective To study the clinical value of 64-slice spiral CT three-dimensional reconstruction imaging in hepatocellular carcinoma. Methods From November 2005 to July 2006, 34 cases of primary hepatocellular carcinoma were examined by 64-slice spiral CT three-dimensional imaging in Zhujiang Hospital of Southern Medical University. The clinical data were compared with those of intraoperative exploration, surgical methods and interventional therapy Evaluation. Results Thirty-four patients with primary liver cancer underwent three-dimensional reconstruction by 64-slice spiral CT. The tumor showed no invasion of adjacent tissues and blood vessels in 23 cases, 9 cases of adjacent blood vessels in the tumor, 1 case of arteriovenous fistula and 1 case of portal vein tumor thrombus. Three patients underwent TACE (transcatheter hepatic arterial chemoembolization), and the remaining 31 patients underwent surgical treatment. The results were consistent with the findings of intraoperative exploration in 30 cases, with a correct rate of 96.7%. Radical resection in 12 cases, right hemihepatectomy in 8 cases, left lobectomy in 5 cases, left hemihepatectomy in 2 cases, left hepatectomy plus portal vein thrombectomy in 1 case, left-sided lobectomy in 1 case, right-third 1 case of lobectomy, 1 case of caudate lobectomy. Conclusion 64-slice spiral CT three-dimensional imaging can well display the boundaries of the tumor, involving the scope, in particular, can accurately determine the relationship between the tumor and the liver vessels, blood vessels to fully understand the situation of variation, the results of the degree of lesion evaluation and guidance of surgical treatment have a choice Important value.