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Objective To discuss the clinical value of interventional transcatheter arterial chemoembolization(TACE)combined with subsequent pelvic radiotherapy in treating patients with advanced cervical cancer.Methods According to the therapeutic scheme,195 patients with phase Ⅱb or beyond advanced cervical cancer were divided into two groups: (1)study group(n=99),treated with TACE combined with subsequent pelvic radiotherapy(I.e.combination group);(2)control group(n=96),treated with radiotherapy alone(I.e.radiotherapy alone group).The short-term and long-term clinical results as well as the occurrence of complications were compared between two groups.Results Different degrees of the tumor shrinkage were found in patients of both groups after treatment.The short-term remission rate of the study group was significantly higher than that of the control group,and the difference between two groups was statistically significant(P=0.012).After the procedure,the anaemia in patients of study group was markedly corrected.The difference in hemoglobin between preoperative levels and postoperative ones was significant(T-test,P＜0.01).Long-term follow-up for 3 years the survival rate of the study group was higher than that of the control group(P=0.032).Both the recurrence rate and metastatic rate at one and three years after the therapy in the study group were distinctly lower than that in the control group(P＜0.05).No significant difference in one-year,five-year survival rate and in five-year recurrent rate existed between two groups.The main short-term complications included digestive untoward reaction,bone marrow depression,hepatic and renal toxicity,etc.,which could be well relieved after active symptomatic medication.The longterm complications included radiodermatitis,radiocystitis and/or radioproctitis.The incidence of radiocystitis and radioproctitis in the study group was significantly lower than that in the control group(P＜0.05).Conclusion TACE combined with subsequent pelvic radiotherapy is an effective therapy for advanced cervical cancer,its clinical result is superior to simple radiotherapy.This therapy tan enhance both the short-term and the tong-term effects,relieve the clinical symptoms,reduce the occurrence of long-term complications,thus,improve the quality of life and prolong the survival time of patients.
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Purpose To explore the value of 64-slice spiral CT digital subtraction angiography in diagnosis of cerebral arteriovenous malformations (AVM).Materials and Methods 26 patients with AVM were performed with plain CT scan, enhanced arterial phase and venous phase CT scan on a 64-slice spiral CT scanner. The subtracted arterial phase data was obtained through subtracting the plain CT images from arterial phase images, then the subtracted venous phase data was obtained through subtracting arterial phase images from venous phase images, and subtracted mixed arterial-venous phase data through subtracting plain CT images from venous phase images. Then volume rendering (VR) and maximum intensity projection (MIP) were used to reconstruct the cerebral vessel images. Results The inference of cranial bones was completely removed in all subtracted cerebral vessel images, thus clearly demonstrating malformed vascular nest, feeding arteries and draining veins. And 7 malformed temporal vascular nests, 5 parietal vascular nests, 5 frontal vascular nests, 6 occipital vascular nests and 3 cerebellar vascular nests were revealed;39 feeding arteries were detected altogether. Single feeding artery was found in 15 cases, and multiple feeding arteries in 9 cases. Meanwhile 33 draining veins were observed, and single draining vein was found in 10 cases, multiple veins in 16 cases.Conclusion 64-slice subtraction angiography can remove the inference of cranial bones and clearly demonstrate the feeding arteries, malformed vascular nests, draining veins, potentially providing a reliable evidence for therapeutic planning and postoperative follow-up.
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Objective To evaluate the usefulness and necessity of spiral computer tomography (SCT) and color-Doppler ultrasonography (CDU) in primary hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods Plain SCT scanning and contrast-enhanced SCT scanning or / and CDU were performed for 68 HCCs before and four weeks after TACE. Factors related to overall survival (OS) were observed as tumor size necrosis, relapse, lipiodol deposition, blood supply of the survived tumor. Images of SCT and CDU were compared. Clinical significance obtained through direction of diagnostic radiology was evaluated. Results 139 masses observed in the 68 cases were shranked or necrotized in a different degree after TACE. 8 new metastasized massed were observed. Complete lipiodol deposition was observed in 27 masses and no lipiodol deposition in 14 masses. As for estimating the types of lipiodol deposition, SCT was better than CDU with significant difference. SCT could indirectly estimate the blood supply of tumor after TACT through 3 dynamic enhanced phases, while CDU could directly visualize the hemodynamic changes of liver, internal and peripheral parts of the tumor. Conclusion TACE is an effective way to treating HCC. SCT scanning and / or CDU are necessary before and after TACE to estimate the imaging changes so as to provide indispensable information for the best therapeutic schedule in the future.
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Objective To explore the characteristics of CT image and pathological changes of intrahepatic lymphatic stasis(ILS) caused by hepatic diseases.Methods Clinical data and CT images in contrast-enhanced arterial phase and portal venous phase in 36 cases with ILS saused by hepatic cancer,cirrhosis,hepatic metastatic tumors,hepatitis and hepatic contusion were analyzed retrospectively.The etiological mechanism of ILS was also discussed.Results On contrast-enhanced SCT scan,low-density line or annular line around the branches of hepatic vein,portal vein and/or intrahepatic inferior vena cava were found in all case,they presented as a kind of "halo sign" around the blood vessel.Conclusion The CT finding of ILS in hepatic diseases is quite characteristic and it is of great value in diagnosis of ILS.