多层螺旋CT及胃左动脉CTA在胃贲门癌介入治疗的应用价值

目的 探讨多层螺旋CT及胃左动脉CT血管造影(CTA)在胃贲门癌介入治疗中的应用价值.方法 选取2014年3月至2017年6月胃贲门癌患者46例,所有患者均行多层螺旋CT及胃左动脉CTA检查,再行胃左动脉数字减影血管造影(DSA)检查和介入化疗、栓塞治疗.结果 46例患者均顺利完成多层螺旋CT及胃左动脉CTA检查,发现变异胃左动脉解剖结构9例,以DSA检查结果为标准进行比较,CTA对胃左动脉解剖结构诊断的敏感性、阳性预测值均达100%,Kappa系数为1.000,二者一致性高.CTA检查贲门部肿瘤供血情况,发现60条供血动脉,其中46条胃左动脉,8条左膈下动脉,2条胃右动脉,4条肝左动脉,与DSA结果比较,肿瘤供血血管显示率达98.36%.结论 多层螺旋CT及胃左动脉CTA能有效显示胃左动脉血管解剖结构和肿瘤供血动脉,对胃贲门癌的介入治疗有重要指导意义.

Objective To explore the application value of multi-slice spiral CT and left gastric artery CTA in the interventional treatment of gastric cardia cancer.Methods 46 patients with gastric cardia cancer treated in our hospital from March 2014 to June 2017 were selected as the subjects,all the patients underwent multi-slice spiral CT and left gastric artery CT angiography(CTA)examinations of the left gastric artery(CTA),then the left gastric artery digital subtraction angiography(DSA)examination and the interventional chemotherapy,embolotherapy were performed.Results All the 46 patients successfully completed the multi-slice spiral CT and the CTA examination of the left gastric artery,9 cases were found the variant anatomical structure of the left gastric artery,the DSA examination results were taken as the standard,the sensitivity and positive predictive value of CTA to the anatomical structure of the left gastric artery were 100%,the Kappa coefficient was 1.000,and the two had a high consistency.The CTA examination of gastric cardia tumor blood found that there were 60 blood supply arteries,including 46 left gastric artery,8 left inferior phrenic artery,2 right gastric artery,4 left hepatic artery,compared with the DSA results,the vessel display rate of tumor blood supply was 98.36%.Conclusion The multi-slice spiral CT and the left gastric artery CTA can effectively display the vascular anatomy of the left gastric artery and the blood supply artery of the tumor.It has important guiding significance for the interventional therapy of gastric cardia cancer.