Ebara M, Kita K, Sugiura N, Yoshikawa M, Fukuda H, Ohto M, Kondo F, Kondo Y
First Department of Medicine, School of Medicine, Chiba University, Japan.
Radiology. 1995 May;195(2):371-7. doi: 10.1148/radiology.195.2.7536946.
To evaluate the therapeutic effect of percutaneous ethanol injection (PEI) on small hepatocellular carcinoma (HCC) with computed tomography (CT).
Sixty-seven patients with histologically proved HCC 3 cm or less in diameter underwent PEI. The patients were regularly followed up with sonography and contrast material-enhanced CT for more than 1 year (range, 12-96 months). The CT findings were evaluated for three tumor types distinguished on the basis of their appearance relative to that of the surrounding liver parenchyma: type 1 = hyperattenuating at the early phase (n = 39), type 2 = iso- or hypoattenuating at the early phase and hypoattenuating at the late phase (n = 18), and type 3 = isoattenuating (not detected) at both the early and late phases (n = 10).
After PEI, a necrotic area of HCC and the surrounding liver parenchyma was characterized as hypoattenuating at both early and late phases of contrast-enhanced CT, regardless of the type. When an HCC appeared to be completely necrotic within 3 months after PEI, this status was retained until the latest observation in all but three cases.
Contrast-enhanced CT can correctly depict PEI-induced necrosis in HCC and is reliable for evaluating the therapeutic effect of PEI.
通过计算机断层扫描（CT）评估经皮乙醇注射（PEI）治疗小肝细胞癌（HCC）的疗效。
67例经组织学证实的直径3 cm及以下的HCC患者接受了PEI治疗。对患者进行定期超声检查和对比剂增强CT随访超过1年（范围为12 - 96个月）。根据肿瘤相对于周围肝实质的表现区分出三种肿瘤类型，并对CT表现进行评估：1型 = 早期高密度（n = 39），2型 = 早期等密度或低密度，晚期低密度（n = 18），3型 = 早期和晚期均为等密度（未检测到）（n = 10）。
PEI治疗后，无论肿瘤类型如何，HCC及周围肝实质的坏死区域在对比增强CT的早期和晚期均表现为低密度。如果HCC在PEI治疗后3个月内看起来完全坏死，除3例病例外，这种状态一直保持到最近一次观察。
对比增强CT能够正确描绘PEI诱导的HCC坏死情况，并且在评估PEI的治疗效果方面是可靠的。
