摘要
目的 探讨CT引导下肝脏恶性肿瘤经皮穿刺酒精注射 (PEI)治疗的技术及临床价值。资料与方法 16 8例患者中 2 6 5个原发或继发恶性肿瘤在CT引导下行PEI,每次治疗注射足量酒精 (5～ 40ml) ,并尽可能使酒精弥散区覆盖全部或大部肿瘤。治疗后 3个月行CT多期扫描或增强MRI复查。结果 2 6 5个病灶在CT引导下成功施行了PEI治疗 ,其中 37个位置靠近膈肌或肝硬化结节干扰B超不能显示或显示不清 ,只能在CT引导下行PEI。对于体积小、位置深不易穿中的病灶 ,应用可弯曲穿刺针可减少穿刺次数 ,缩短操作时间。 117个≤ 3cm的肿瘤行PEI治疗时酒精覆盖全部病灶 ,3个月后复查 87.2 %的病灶完全坏死 ;酒精覆盖全部病灶的 3～ 5cm肿瘤 6 4个 ,3个月后复查 73.4%的病灶完全坏死 ;部分 3～ 5cm肿瘤以及全部 >5cm的肿瘤行PEI结合经导管肝动脉化疗栓塞术(TACE)治疗后 ,均大部分或完全坏死。无严重并发症。结论 CT作为引导工具 ,可对B超不能显示或显示不清的病灶行PEI治疗 ,CT引导PEI对酒精弥散范围显示清楚、注射酒精量足、治疗次数减少。
Objective To investigate the technical points of CT-guided percutaneous ethanol injection (PEI) and its clinical value in the treatment of hepatic neoplasm.Materials and Methods CT-guided PEI was performed for the treatment of 265 primary or secondary malignant hepatic lesions in 168 patients. In each procedure, 5～40 ml ethanol was injected, the volume used was enough to infiltrate the whole lesion or the most part of the lesion. Follow-up checkups with multiphase enhanced CT or enhanced MRI for all patients were made in 3 months.Results 265 tumors received PEI successfully under CT guidance, 37 couldn't be detected or well shown on ultrasonography because they located near diaphragm or were accompanied by severe cirrhosis, and PEI could be only carried out under CT guidance. For small and deep lesions, which were difficult to puncture, the flexible needles were used. In 117 tumors with a diameter of 3cm or less, the ethanol infiltrated the whole lesion, and complete necrosis of the lesion was obtained in 87.2% in 3 months. In 35 tumors of 3～5cm diameter with the ethanol infiltrating the whole lesion, complete necrosis of the lesion was seen in 73.4% in 3 months. In some tumors of 3～5cm diameter and in all tumors over 5cm, which were treated with both PEI and TACE, the whole or most part of the lesion became necrotized during the follow-up period. No severe complications occurred. Conclusion CT-guided PEI can be effectively used to treat the tumors difficult to detect on ultrasonograph with high necrotic rate of the lesions. Under the guidance of CT, the infiltration of ethanol can be clearly demonstrated. In order to obtain an excellent result, enough ethanol should be used.
出处
《临床放射学杂志》
CSCD
北大核心
2002年第7期553-556,共4页
Journal of Clinical Radiology
基金
上海市科学技术发展基金资助项目 ( 0 0 41190 76 )
关键词
肝肿瘤
经皮酒精注射
CT引导
治疗
Tomography, X-ray computed Hepatic neoplasm Percutaneous ethanol injection
