Furuichi Kenji, Furukawa Akira, Takahashi Masashi, Murata Kiyoshi
Department of Radiology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
Hepatol Res. 2004 Apr;28(4):191-197. doi: 10.1016/j.hepres.2003.12.001.
The purpose of this study was to evaluate the role of combined CT hepatic angiography (CTHA) and CT during arterial portography (CTAP) in the diagnosis and management of patients with hepatocellular carcinomas (HCC) and liver metastases. Fifty patients with HCC and 19 patients with liver metastases were referred for CTHA and CTAP prior to surgery or interventional therapy. Diagnosis was established by either surgery or clinical observation. Alterations of diagnosis and management resulting from CTHA and CTAP information were recorded. In patients with HCC, diagnosis was altered either by number, location or extent of lesions in 46% of patients and was 78% correct. Alterations of management were performed in 32% of the patients in total, and were correct in all but one. In patients with liver metastases, diagnosis was altered regarding either number, location or extent of lesions in 21% of patients and were 50% correct. Management was not altered after CTHA and CTAP in the patients with liver metastases. We conclude that CTHA and CTAP provide valuable clinical information for patients with HCC and significantly corrected their previous diagnosis and plans of management. CTHA and CTAP should be performed in patients with HCC when either surgical or interventional therapy is the treatment option.
本研究的目的是评估联合CT肝血管造影（CTHA）和动脉性门静脉造影CT（CTAP）在肝细胞癌（HCC）和肝转移瘤患者诊断及治疗中的作用。50例HCC患者和19例肝转移瘤患者在手术或介入治疗前接受了CTHA和CTAP检查。通过手术或临床观察确诊。记录CTHA和CTAP信息导致的诊断和治疗改变。在HCC患者中，46%的患者病变数量、位置或范围的诊断发生了改变，诊断正确率为78%。总共32%的患者治疗方案发生了改变，除1例之外全部正确。在肝转移瘤患者中，21%的患者病变数量、位置或范围的诊断发生了改变，诊断正确率为50%。肝转移瘤患者在CTHA和CTAP检查后治疗方案未改变。我们得出结论，CTHA和CTAP为HCC患者提供了有价值的临床信息，并显著修正了他们之前的诊断和治疗方案。当手术或介入治疗作为治疗选择时，HCC患者应进行CTHA和CTAP检查。
