肝癌介入治疗后并发胆汁瘤CT表现及临床意义

摘要

目的 探讨肝癌介入治疗后肝内胆汁瘤形成的CT表现及临床意义.方法 回顾分析2013年6月至2016年6月在该院行肝动脉灌注化疗栓塞术(TACE)的387例肝癌患者的临床资料,患者在介入治疗后均进行CT复查,观察术后并发胆汁瘤的CT表现.结果 患者介入治疗后出现胆汁瘤11例,发生率为2.84%.9例患者CT显示为囊状胆汁瘤,其中3例囊状影边界清晰,4例近癌边缘模糊远癌边缘清晰,2例边缘模糊;2例患者CT显示为柱状胆汁瘤,边界较为模糊.8例患者经临床利胆、保肝保守治疗后瘤体明显变小,3例患者的瘤体直径超过5 cm,经皮肝穿刺胆汁引流后,瘤体均逐渐变小消失.结论 胆汁瘤是肝癌患者微创介入治疗后常出现的并发症,可通过CT诊断检出,并采用保肝利胆、穿刺引流等进行有效治疗.%Objective To investigate the CT manifestations and clinical significance of biloma formation after interventional treatment of hepatocellular carcinoma(HCC).Methods The clinical data of 387 patients with HCC who underwent transcatheter arterial chemoembolization(TACE) in our hospital from June 2013 to June 2016 were retrospectively analyzed.The patients were reexamined by CT after interventional therapy and the CT manifestations of bile tumor were described.Results There were 11 cases of bile tumor after interventional treatment,and the incidence was 2.84%.The CT of 9 patients showed cystic tumor,in which 3 cases had clear margins,4 cases had blurred edge in the near-cancerous region and clear edge in the distal cancer area,2 cases had blurred borderline.The CT of another 2 patients showed columnar bile tumors,and the boundary was blurred.The bile tumor of 8 cases of patients was significantly smaller after the liver and choleretic treatment.The tumor of 3 cases,whose tumor diameters were more than 5 cm,were gradually smaller and disappeared after percutaneous biliary drainage.Conclusion Biloma is a common complication in patients with hepatocellular carcinoma after interventional treatment.It can be diagnosed by CT and treated effectively with liver protection and cholagogue or percutaneous biliary drainage.