16排螺旋CT血管成像对腹腔镜下胃切除术的价值

Value of 16-slice CT Angiography in Preoperative Assessment of Vascular Anatomy of Stomach Before Laparoscopy-assisted Gastrectomy

目的探讨腹腔镜辅助下胃切除术前16排螺旋CT血管造影(MSCTA)评价胃周血管解剖的价值。资料与方法24例拟行腹腔镜辅助下胃远端切除术的患者行MSCT双期扫描,其动、静脉期图像采用容积再现重组技术分别行三维CTA。结果24例中三维CTA准确显示胃左动脉24例,胃右动脉23例,胃左静脉24例。6例CTA伴有替代肝左动脉。CTA显示胃左动脉、胃左静脉和替代肝左动脉敏感性和阳性预测值均为100%;显示胃右动脉敏感性为100%,阳性预测值为96%。结论MSCTA能够准确评价胃的血管解剖,有利于腹腔镜辅助下胃远端切除术。

Objective To evaluate the value of CT angiography （CTA） in the preoperative assessment of the vascular anatomy of the stomach before laparoseopy assisted gastrectomy. Materials and Methods 24 consecutive patients for laparoscopy assisted gastrectomy underwent dual phase enhancement scanning on MSCT. Three-dimensional CT angiography was reconstructed using volume rendering technique based on arterial phase images and venous phase images. Results Three-dimensional CTA showed the left gastric artery in 24 cases, right gastric artery in 23 cases, left gastric vein in 24 eases, and alternative left hepatic artery in 6 cases. Both the sensitivity and positive predictive value of displaying the left gastric artery, left gastric vein, and alternative left hepatic artery were 100%. The sensitivity and positive predictive value of displaying the right gastric artery was 100% and 96% , respectively. Conclusion Three-dimensional CTA using MSCT could clearly reveal vascular anatomy of the stomach, which might play an important role in facilitating the laparoscopy assisted gastrectomy procedure.