摘要
肝癌术后转移复发的早期发现和诊断依赖于特异性标记物和影像学检查,而后者的作用最为重要。综合比较肝癌的常规影像学诊断方法,彩超费用低廉且易于普及,操作便捷,是肝癌治疗后随访和复发早期发现的首选手段,但存在盲点和受操作者技术限制。CT图像清晰稳定,可用于超声检查怀疑肝癌复发的进一步确认和补充。MRI的软组织分辨率高,对肝癌尤其是小肝癌的诊断灵敏度和特异度已经超过CT检查,渐被更多临床医生作为首选。放射性核素显像对小肝癌的诊断灵敏度较低,其应用价值需要进一步研究。一般建议病人术后每2个月进行1次随访,进行甲胎蛋白(AFP)测定和超声波检查,每年检查1次增强MRI或CT。一旦怀疑有复发,建议增强MRI或CT进一步确诊。
Imaging diagnostic techniques play very important roles in the early detection and diagnosis of postoperative recurrence of hepatocellular carcinoma （HCC）. Because of its cost-effectiveness, ultrasonography （US） Still keeps a preferred place for routine screening of HCC in patients with liver disease as well as for surveillance in postoperative patients. Compared with US, computed tomography （CT） has a higher sensitivity in small HCC diagnosis, and is widely used to detect and characterize liver lesions. Due to the technical advances in hardware and software that allow the acquisition of images with excellent anatomic detail： and the novel tissue-specific contrast agents, magnetic resonance imaging （MRI） has played more and more significant roles in the early detection of HCC recurrence, which has been the first choice.MRI has been proved to be more sensitive and specific than CT, particularly for the detection of very small nodules of HCC recurrences. Positron emission tomography （PET） is not proved to be more useful and sensitive in diagnosis, prognosis and therapeutic effect judgement of HCC. It usually suggests the HCC patients receive regular serum AFP detection and US every two months, and enhanced CT or MRI each year during the follow-up after operation; when the tumor recurrence is suspected by the AFP and US, enhanced MRI/CT is recommended to make the diagnosis.
出处
《中国实用外科杂志》
CSCD
北大核心
2012年第10期817-821,共5页
Chinese Journal of Practical Surgery
关键词
原发性肝癌
术后复发
影像诊断
primary hepatocellular carcinoma
postoperative recurrence
imaging diagnosis
