PET／CT对TACE联合RFA治疗原发性肝癌的疗效评价-论文.pdf

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1、·34·医刊2013年11月第40卷第22期ChineseJournalofPracticalMedicineNov．2013．Vol_40．No．22PET／CT对TACE联合RFA治疗原发性肝癌的疗效评价蔡越飞钟胜冼重杨谭小明贾志斌高中山【摘要】目的探讨PET／CT在经动脉导管栓塞化疗(TACE)联合射频消融(RFA)治疗原发性肝癌后的应用价值。方法本组21例原发性肝癌患者共有31个病变，肿瘤最大径为1．0—12．5cm。其中15例为初治病例，6例为肝癌手术后复发。经过TACE联合RFA治疗后3周，对比CT和PET／CT检查的结果。如发现有肿瘤残留，在1周内

2、对其再次行RFA治疗。结果21例患者经一次TACE联合一次RFA治疗3周，经病变区域活检及数字减影血管造影等检查发现19例有部分肿瘤残留，肿瘤残留最大径为0．5～3．5cm。cT增强扫描检查检出10例，检出率为52．6％；PET／CT检出有17例残留，检出率为89．5％。根据PET／CT检查结果，在1周内再次行RFA治疗，PET／CT检查发现16例患者肿瘤无残留，1例患者3周后复查PET／CT发现肝内病变未完全控制，行第3次RFA。结论原发性肝癌经TACE联合RFA治疗后，PET／CT对判断肿瘤残留以及指导进一步RFA治疗较CT检查具有更大的优势。【关键词】原发

3、性肝癌；射频消融；经动脉导管栓塞化疗；PET／CTEficacyevaluationoftranscatheterarterialchemo-embolizationcombinedwithradiofrequencyablationonpatientswithhepatocellularcarcinomabyPET／CTCAIYue，ZHONGSheng，XIANChong—yang，TANXiao—ming，JlAzhi—bin，GAOZhong—shan．DepartmentofInterventionalRadiol—ogy，DonghuaHospita

4、lofDongguan，Dongguan523110，China【Abstract】ObjectiveToinvestigatethevalueofPEI1／cTinjudgingtumorresidueofhepato—cellularcarcinoma(HCC)aftertreatedbytranscatheterarterialchemo—embolization(TACE)combinedwithradiofrequencyablation(RFA)．MethodsTwentyoneHCCpatientswith31lesions，1．0—12．5cmi

5、ndiameter．weretreatedinourhospitalfromDecember2009toDeeember2011．0fthe21patients．15caseswerenaivepatientswith21lesions，6patientswererelapsedafterhepatectomy．TheresultsofCTandPET／CTofthe21patients3weeksaftertreatmentofTACEcombinedwithRFAwerecompared．Iftumorresiduewasdictated，afurtherR

6、FAtreatmentwouldbeappliedwithinoneweek．ResultsOfthe21HCCpatientsthatreceivedonecourseofTACEcombinedwithRFA，19caseshadtumorresidueswhichwereconformedbyfineneedlebiopsyanddigitalsubstractionangiography(DSA)．CTonlydetec—ted10positivecases；however，PET／CTdetected17positivecases．Positivera

7、teofCTwas52．6％，andthatofPET／CTwas89．5％．AccordingtotheresultsofPET／CTofthe17patients．afterthesecondcourseofRFA．16patientshadriotumorresidue。lcasesurvivedwithuncontrolledlesions3weeksaftertreatment．ConclusionsPET／CTisbetterthanCTiniudgingtumorresidueofHCCaftertreatmentofTACEcombinedwit

8、hRFA．andingu