【摘要】 目的探讨多层螺旋CT血管成像(MSCTA)对肝癌经导管动脉内化疗栓塞(TACE)插管操作的指导价值。资料与方法对临床确诊的80例肝癌患者分别行MSCTA和数字减影血管造影(DSA)检查。对比分析:肝癌供血血管的起源、走行、形态、变异以及寄生供血、腹腔动脉与腹主动脉的夹角;比较MSCTA与DSA的符合情况,分析MSCTA对TACE插管操作的指导价值。结果MSCTA中最大密度投影(MIP)和容积再现技术(VRT)对肝癌规则性供血情况下二级肝动脉的显示率分别为97.5%、95%。MIP和VRT对三级肝动脉的显示率分别为96.25%、75%。MSCTA与DSA对二级肝动脉显示率差异无统计学意义(P>0.05),对三级肝动脉的显示率,MIP与DSA图像差异无统计学意义(P>0.05),VRT与DSA差异有统计学意义(P<0.05)。MSCTA显示寄生动脉20支,肝动脉变异18例;DSA显示寄生动脉24支,显示肝动脉变异21例;MSCTA发现肝癌寄生动脉和肝动脉解剖变异的阳性率分别为83.3%和85.7%。MSCTA和DSA在发现寄生动脉和肝动脉解剖变异概率上的差异无统计学意义(P>0.05)。MSCTA显示腹主动脉和腹腔干动脉在矢状面夹角狭窄4例,横断面极度左偏3例;MSCTA显示情况与DSA吻合。结论MSCTA与DSA比较具有高度的一致性;它能全方位详尽清晰地显示肝动脉分支的起源、走行、形态;检出肝癌变异供血动脉及肝外寄生供血动脉,显示腹腔干动脉与腹主动脉的夹角,对指导TACE术中插管操作具有重要价值。更多还原

【Abstract】 Objective To discuss the guidance value of multi-slice spiral CT angiography(MSCTA) to the intubatton in the transcatheter arterial chemoembolization(TACE).Material and Methods The hepatic arterial phase MSCTA were performed in eighty patients on a Toshiba Aquilion sixteen slice spiral CT scanner.Maximum intensity projection(MIP),volume reconstruction technique(VRT) were used to reconstruct the hepatic vessels,and to display the hepatic tumor vascular.All the cases were compared with digital substraction angiography(DSA),which compared the class of branches,origination,and configuration of hepatic artery and tumor vascular;the clamp of abdominal aorta and celiac trunk;all of these directly infect the intubatton.We would study the accord between MSCTA and DSA,And analyse the guidance value of multi-slice spiral CT angiography to director the intubatton in TACE.Results The displaying rates of the two class hepatic artery in regulation blood by MIP and VRT were respectively 97.5% and 95%.The displaying rates of MIP and VRT to three class hepatic artery were respectively 96.25%、75%.Between MSCTA and DSA,there are no significantly statistic differences in displaying two class hepatic artery;but in displaying three class hepatic artery there were significantly statistic differences between VRT and DSA;no significantly statistic differences between MIP and DSA.MSCTA display twenty cases of hepatic tumor parasitic blood supply;eighteen cases of hepatic vascular variance;comparing with DSA twenty-four and twenty-one cases,rate of positive was respectively eighty-three dot three percent and eighty-five dot seven percent.There were no significantly statistic differences in discovering hepatic tumor parasitic blood supply.The clamp of abdominal aorta and celiac trunk which MSCTA display,there were four cases straitness in arrowy planes,three cases overly left-leaning in coronary planes;all that MSCTA demonstration were all consistent to DSA.Conclusion Multi-slice spiral CT angiography can exhaustively and three-dimensionally display the anatomy origin and track of hepatic tumor vascular,and can discover the hepatic tumor parasitic blood supply,clearly display the clamp of abdominal aorta and celiac trunk,which all are highly consistent to DSA.MSCTA has a guidance value to director the intubatton in TACE.更多还原