Guan Yong-Song, Hu Ying, Liu Yuan
Department of Interventional Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
J Gastroenterol Hepatol. 2006 Jun;21(6):941-6. doi: 10.1111/j.1440-1746.2006.04474.x.
With the introduction of spiral computed tomography and the development of novel imaging technology in recent years, multidetector-row computed tomography (MDCT) has increasingly been used for the diagnosis of various lesions, especially hepatocellular carcinoma (HCC), due to its volume acquisitions, short scanning time, and especially its double-phase scanning nature, which takes advantage of the dual blood supply of liver. Multidetector-row computed tomography is used to classify HCC into several types based on the blood supply and the histological characteristics of HCC. The evaluation of HCC by MDCT provides crucial clues for the doctors to adopt correct clinical management strategies such as the selection of the appropriate dose of lipiodol before transcatheter arterial chemoembolization (TACE) and the prediction of the prognosis of HCC after TACE. The MDCT scanning allows doctors to choose the region of interest and to evaluate the blood supply according to the lipiodol uptake in order to decide whether there is recrudescence and whether a repeated therapy should be taken. This review describes MDCT, its biphasic scanning, its evaluation of blood supply in HCC and the subsequent classification of HCC, its therapeutic significance before TACE and the prognostic value after TACE.
近年来,随着螺旋计算机断层扫描的引入和新型成像技术的发展,多排探测器计算机断层扫描(MDCT)因其容积采集、扫描时间短,尤其是其利用肝脏双重血供的双期扫描特性,越来越多地用于各种病变的诊断,尤其是肝细胞癌(HCC)。多排探测器计算机断层扫描用于根据HCC的血供和组织学特征将其分为几种类型。MDCT对HCC的评估为医生采取正确的临床管理策略提供了关键线索,如在经动脉化疗栓塞(TACE)前选择合适的碘油剂量以及预测TACE后HCC的预后。MDCT扫描使医生能够根据碘油摄取情况选择感兴趣区域并评估血供,以决定是否复发以及是否应进行重复治疗。本综述介绍了MDCT、其双期扫描、对HCC血供的评估及随后的HCC分类、其在TACE前的治疗意义以及TACE后的预后价值。