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目的探讨多层螺旋CT评价明胶海绵微粒化疗栓塞治疗结直肠癌根治术后肝转移患者的临床疗效的影像学特点。方法回顾性分析31例自2009年12月至2011年12月在我院应用明胶海绵微粒化疗栓塞治疗结直肠癌根治术后肝转移患者的临床资料,评价明胶海绵微粒化疗栓塞前后的多层螺旋CT影像学表现。结果患者术后4天即可见病灶内多个大小不等泡状气体密度影,呈“蜂窝”状改变,术后1个月及3个月复查CT病灶平扫期表现呈类圆形不均匀混杂低密度影,内见散在泡状气体影;增强扫描动脉期病灶内可见低密度无强化坏死区;31例行经肝动脉化疗栓塞术后病灶均有不同程度坏死,完全缓解者(CR):2例;部分缓解(PR):23例;稳定(SD):6例;总有效率(CR+PR)为80%。结论明胶海绵微粒化疗栓塞治疗结直肠癌根治术后肝转移取得良好的近期疗效,多层螺旋CT能准确地判断病灶坏死及残留病灶和新病变的治疗效果,指导再次治疗。
Objective To investigate the imaging features of multi-slice spiral CT in the evaluation of the clinical efficacy of gelatin sponge microparticles in the treatment of patients with liver metastases after radical resection of colorectal cancer. Methods The clinical data of 31 patients with hepatic metastasis after radical resection of colorectal cancer treated with gelatin sponge microparticles in our hospital from December 2009 to December 2011 were retrospectively analyzed. Multilayer spirals before and after chemoembolization with gelatin sponge were evaluated. CT imaging performance. RESULTS: Four days after operation, the blisters in the lesions varied in size and showed a “cellular” appearance. The CT scans at 1 and 3 months after surgery showed a round shape. Non-homogeneous mixed low-density shadows were seen in vacuoles in the alveolar airways; low-density non-enhanced necrotic areas were seen in the enhanced scan arterial phase lesions; 31 cases of transhepatic arterial chemoembolization had varying degrees of necrosis in the lesions, complete remission ( CR): 2 cases; partial remission (PR): 23 cases; stable (SD): 6 cases; total effective rate (CR+PR) was 80%. Conclusion Gelfoam microparticles chemoembolization has a good short-term efficacy in the treatment of liver metastasis after radical resection of colorectal cancer. Multi-slice spiral CT can accurately determine the therapeutic effects of focal necrosis and residual lesions and new lesions, and guide the retreatment.