摘要
目的：探讨双能量 CT 血管成像（ DECTA）与 DSA 在原发性肝癌经导管化疗栓塞（TACE）术中协同应用的价值。方法前瞻性分析2013年8月—2014年8月复旦大学附属华东医院放射科采用 TACE 术治疗的98例原发性肝癌患者的临床资料，其中男70例，女28例，年龄47-84岁。按照完全随机化分组设计将患者随机分为2组：对照组48例，在 TACE 术前不行 DECTA 检查；观察组50例，在 TACE 术前行 DECTA 检查，并行 VR、最大密度投影（MIP）和多平面重建（MPR）。对2组患者术中查找肿瘤供血动脉数量、术中选用导管数量、对比剂用量、减影采集序列次数、透视时间、手术时间、剂量辐射乘积和超选程度进行对比分析。结果98例均完成检查和 TACE 术。2组TACE 术的超选程度差异无统计学意义（P 〉0.05），但在查找肿瘤供血动脉数量上，观察组（2.72±0.89）条多于对照组（1.88±0.74）条，差异有统计学意义（P 〈0.01）；在选用导管数量、对比剂用量、减影采集序列次数、透视时间、手术时间和剂量辐射乘积方面，观察组均少于对照组，差异均有统计学意义（P 值均〈0.05）。对腹腔动脉变异及肝外寄生血管为肿瘤提供血供的显示，观察组也优于对照组。观察组未出现手术并发症，而对照组中有4例术中出现上腹部急性疼痛。结论 DECTA 与 DSA在原发性肝癌介入治疗中的协同应用是合理、可行的操作方案。
Objective To evaluate the synergistic effect of dual-energy computed tomography angiography （ CTA） and digital substraction angiography （ DSA） on transcatheter chemoembolization of hepatocellular carcinoma. Methods Transcatheter chemoembolization was performed in 98 patients with hepatocellular carcinoma from Aug. 2013 to Aug. 2014. The patients were divided into two groups randomly. Fifty patients underwent dual-energy CTA before transcatheter chemoembolization were regarded as group 1 with post-procession of VR, MIP and MPR; meanwhile other 48 patients were regarded as group 2 without CTA. The number of tumor-feeding vessels and used catheters, dose of contrast medium, amount of DSA series, time of exposure and operation, dose area product, and degree of transcatheter chemoembolization were compared. Results All tumor-feeding vessels in group 1 were observed by dual-energy CTA clearly with exact display of the origin, course, and diameter of the vessels. The number of tumor-feeding vessels in group 1 was 2. 72 ± 0. 89,more than that in group 2（1. 88 ± 0. 74）, exhibiting a statistical difference between two groups （ P 〈 0. 01）. The number of catheters used, dose of contrast medium, amount of DSA series, time of exposure and operation, and dose area product in group 1 were less than those in group 2, also exhibiting the statistical difference （ all P values 〈 0. 05）. Conclusions Combination of dual-energy CTA and DSA is reasonable and practicable, which has synergistic effect on interventional therapy for hepatocellular carcinoma.
出处
《中华解剖与临床杂志》
2015年第5期405-409,共5页
Chinese Journal of Anatomy and Clinics
关键词
癌
肝细胞
体层摄影术
X
线计算机
导管插入术
化学栓塞
治疗性
血管造影术
数字减影
Carcinoma,hepatocellular
Tomography,X-Ray computed
Catheterization
Chemoembolization,therapeutic
Angiography,digital subtraction
