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肝癌行肝动脉栓塞术(TAE)后,在肿瘤边缘残存的癌细胞常常再发,必须再次治疗。对其早期发现,用超声波断层法(US)无效,如不进行动态CT观察也不能确诊。用超声脉冲多普勒(PDUS)可检出肿瘤部位血流的再通,以此有可能进行早期诊断,作者对此进行了研究。方法:研究对象为进行TAE后确认肿瘤血流断绝的肝细胞癌17例,21个肿瘤病灶。于TAE后定期用US、CT及CT造影对肿瘤病灶进行观察,在未怀疑再发时由主治医生选择时问进行血管造影(AG)和PDUS检查。各图象诊断以下列标准判定再发。US:肿瘤直径增大,进行性血管浸润;CT:碘化油周围低吸收区域扩大;AG:肿瘤血管增生。结果:AG、US、CT各检出再发病灶15个、4个、5个。用PDUS检查出的14个病灶是从肿瘤边缘部位发现的(动脉波动型3个,非动脉波动型1个,非波
After liver cancer undergoing hepatic artery embolization (TAE), cancer cells that reside on the edges of the tumor often recur and must be treated again. For its early detection, ultrasonic tomography (US) was ineffective and could not be diagnosed without dynamic CT. The authors studied the possibility of detecting the recanalization of the blood flow at the tumor site using Ultrasonic Pulse Doppler (PDUS), which makes possible early diagnosis. Methods: Twenty-seven patients with hepatocellular carcinoma and twenty-one tumor lesions were confirmed after TAE. After the TAE, tumor lesions were regularly observed with US, CT, and CT angiography. The angiography (AG) and PDUS examinations were performed when the attending physician chose the time when there was no doubt about recurrence. Each image diagnosis was determined by the following criteria. US: Increased tumor size, progressive vascular invasion; CT: Expansion of low-absorbed areas around iodized oil; AG: Tumor vascular hyperplasia. RESULTS: A total of 15 lesions, 4 lesions and 5 lesions were detected in each of AG, US and CT. The 14 lesions detected with the PDUS were found from the edge of the tumor (3 arterial undulations, 1 non-arterial undulatory, non-wave