干旱区生态环境知识资源中心(Arid): 肝癌射频治疗后的血管造影表现

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	肝癌射频治疗后的血管造影表现
其他题名	Angiographic Manifestations of Hepatocarcinoma After Radiofrequency Ablation Treatment
	李文涛; 王建华; 颜志平; 程洁敏; 刘清欣; 刘嵘; 张大江; 王平
来源期刊	临床放射学杂志
ISSN	1001-9324
出版年	2003
卷号	22 期号:5 页码:408-411
中文摘要	目的了解肝癌射频治疗后的DSA征象，为评价肝癌射频治疗的疗效和选择理想的术后影像学随访手段提供参考。资料与方法本组共8例，原发性肝癌7例，转移性肝癌1例；6例为单发病灶，2例各为2个病灶(1例为原发，1例为转移)；肿瘤直径3～7.5cm(平均4.3cm)。肝总动脉及可疑区域供血动脉超选择性造影。结果 DSA表现：射频治疗的肿瘤区多为圆形或类圆形无染色的低密度区；边缘区可见以下几种征象：(1)局部染色：(2)肝动脉门静脉瘘：(3)边缘区出血；(4)边缘复发；(5)无异常造影征象。肝内异位复发灶造影表现同其原发肿瘤常见造影表现。本组7例造影发现原位边缘复发和/或肝内异位复发灶。结论发现和鉴别射频治疗区域的边缘征象是判断局部复发的关键。(1)肉芽组织染色为治疗区边缘常见征象，多见于治疗后1个月内。(2)局部肝动脉门静脉瘘是射频治疗的并发症，常因局部肝动脉灌注不足和门静脉异常灌注，掩盖局部复发征象。(3)边缘出血与局部复发的鉴别要点在于：前者为片状染色，时相更早，门静脉显影后仍有对比剂存留；边缘复发多为结节状，分布不均，突出于治疗轮廓以外。(4)射频治疗3个月后，原肿瘤病灶边缘应无异常血管征象，若有染色应考虑复发。DSA在检出<1cm的边缘结节复发和肝内复发灶方面优于CT。
英文摘要	Objective To sludy the hepatic DSA manifestations of hepatocarcinoma after radiofrequency ablation (RFA) treat-ment, and to provide reference for evaluating RFA effect and selecting proper follow-up imaging technique. Materials and Methods Eight male patients with primary liver oancer ( n = 7) or hepatic metastasis ( n = 1) were enrolled in this study. Soli-tary lesion was seen in 6 and double lesions in 2 oases. Tumor’ s diameter varied within 3-7 .5 cm with a mean of 4.3 cm. Com-mon hepatic arteriography or super-selective angiography of suspicious tumor area were performed in all patients. Results On DSA, most ablated regions presented as round or ovoid low density areas with no slain. At the lesion’ s peripheral zone the follow-ing five signs could be found: (1) stain of localized granulation tissue; (2) arterio-portal fistula; (3) hemorrhage; (4) recur-rence; (5) no abnormal findings. Local or intrahepatic recurrence occurred in 7 cases. Conclusion Hepatic DSA has great val-ue in delecting local recurrence of hepatic tumor after RFA treatment. (1) Granulation staining at the peripheral zone of treated re-gion is a common finding, usually appeared in one month after RFA. (2) Arteriovenous shunt, as a complication of RFA, can cover local recurrence because of hepatic hypo-perfusion and abnormal portal perfusion. (3) Marginal bleeding presents as patch stain in early arterial phase which lasts into portal phase, while marginal recurrence shows signs of nodular shadow which protrudes beyond the oudine of the treated area. (4) No abnormal vascularity should be seen at tumor’s border three months after RFA, olherwise, recurrence should be considered. DSA is superior to CT in detecting marginal or intrahepatic recurrent nodule below lcm.
中文关键词	肝癌 ; 射频治疗 ; 血管造影
英文关键词	carcinoma, hepatic radiofrequency ablation DSA
语种	中文
国家	中国
收录类别	CSCD
WOS类目	MEDICINE GENERAL INTERNAL
WOS研究方向	General & Internal Medicine
CSCD记录号	CSCD:1247103
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/204192
作者单位	复旦大学附属中山医院放射科, 上海 200032, 中国
推荐引用方式 GB/T 7714	李文涛,王建华,颜志平,等. 肝癌射频治疗后的血管造影表现[J],2003,22(5):408-411.
APA	李文涛.,王建华.,颜志平.,程洁敏.,刘清欣.,...&王平.(2003).肝癌射频治疗后的血管造影表现.临床放射学杂志,22(5),408-411.
MLA	李文涛,et al."肝癌射频治疗后的血管造影表现".临床放射学杂志 22.5(2003):408-411.