320排CT血管成像在肝癌介入治疗中的应用

The Application Value of 320-slice CT Angiography in the Interventional Treatment of Liver Cancer

目的探讨320排CT血管成像(CTA)在肝癌介入治疗中的应用价值。方法对103例共行267次介入治疗的肝癌患者,术前均先行320排CT三期扫描及CTA重建,观察肿瘤影像表现及腹腔干和供瘤动脉的起源走行和变异情况,并与DSA比较。结果门静脉癌栓CTA发现41例,DSA发现30例(P<0.05);CTA显示肝总动脉和肝左、右动脉的起源解剖变异率分别为13.6%、10.7%和14.6%,供瘤动脉3级分支以前单处弯曲度<60°有12例,连续2处或2处以上弯曲<90°16例,与DSA显示结果一致;共插管267次,成功超选插管栓塞率99.6%。结论 320排CTA是1种快捷无创的三维、四维血管造影术,能为肝癌的诊断提供更多信息,并能准确显示供血动脉解剖特点,对介入治疗具有积极地指导作用。

Objective To evaluate the value of 320-slice CT angiography ( CTA) in the interventional treatment for hep-atocellular carcinoma .Methods 103 hepatocellular carcinoma patients with a total of 267 times interventional treatment under-went 320-slice CT three-phase scan and the CTA reconstruct before surgery .Tumor imaging ,the travel and variations of the celiac axis and tumor artery were valued ,and compared with the DSA .Results The CTA found portal venous tumor thrombi in 41 cases while 30 cases were found by DSA (P<0.05);The CTA showed that the anatomy origin mutation rate of the left hepatic artery , right hepatic artery and liver artery were 13.6%,10.7% and 14.6%,respectively.Before the artery supplying tumor branch at level 3 the single-bend <60 °was 12 cases,2 in a row or more than 2 bend <90 °was 16 cases,consistent with the DSA mani-festations;Intubation 267 times,successfully super selected embolism rate was 99.6%.Conclusion 320-slice CTA is a quick, non-invasive three and four dimensional angiography .It can provide more diagnostic information and accurately displays the anato-my of the arterial blood supply features for liver cancer ,and positive guidance for interventional treatment .