多排螺旋CT血管造影在肝移植动脉解剖变异分析中的应用

Anatomical variations of hepatic artery: an analysis using MSCTA

目的:探讨多排螺旋CT血管造影(MSCTA)在分析肝移植动脉解剖变异中的应用价值。方法:分析100例预行肝移植术患者的动脉CT血管造影(CTA)资料,并与数字减影血管造影(DSA)(26例)或手术(19例)结果进行对照。所有病例均在ToshibaAquilion16层螺旋CT机上进行。动脉期层厚为1mm,重建层厚为1mm,螺距15,延迟时间25s,对比剂用量为1.5mL/kg。依据Michels分型对100例CTA进行分类,并记录CTA对不同动脉分支的显示率。结果:正常肝动脉解剖占79%,变异占21%。45例有DSA或手术结果者,CTA的诊断符合率为95.6%。结论:MSCTA在分析肝移植动脉解剖变异中有较高的符合率,可应用于肝移植术前的评价。

Objective To evaluate the use of multi-slice spiral CT angiography（MSCTA） in detecting anatomical variations of hepatic artery. Methods MSCTA was performed to detect the hepatic artery in 100 patients scheduled for liver transplantation, 26 of whom also had DSA and 19 underwent surgery. All of the patients were scanned by a Toshiba Aquilion 16-slice MSCT scanner （slice thickness 1 ram, overlap 1 mm, spiral interval 15, delay time in arterial phase 25 s）, receiving an injection of 1.5 mL/kg contrast. The degree of branches and origin of hepatic artery displayed on CT angiography were classified based on Michels＇ classification and the display rate of MSCTA to different artery branches was recorded. Results MSCTA showed 79% of the patients had a normal hepatic artery and 21% occurred variations. The diagnostic accuracy of MSCTA was 95.6% in those 45 patients who had DSA or surgical diagnosis. Conclusion MSCTA has a high accuracy in demonstrating anatomical variations of hepatic artery and may be valuable in the preoperative assessment of liver transplantation.