64层螺旋CT在DIPS术模拟穿刺途径测量中的应用

Application of 64-slice spiral CT on the measurement of puncture channel of simulated direct intrahepatic portacaval shunt

目的通过64层螺旋CT对非肝病患者及肝硬化Child-PughA、B分级组患者肝门静脉左支、右支1、2 cm处与肝后下腔静脉间模拟穿刺途径进行测量,以期为临床DIPS术提供资料。方法选取上腹部64-MSCT扫描非肝病组共39例,肝硬化组16例。用智能追踪技术启动扫描,并将所得数据在GE ADW4.2工作站进行处理。结果非肝病组与肝硬化Child-Pugh A、B分级组肝门静脉左支、右支1、2 cm处直径没有差异性,且呈减小趋势。肝门静脉左支1 cm处与肝后下腔静脉下等分线间距离最短;上、下等分线与肝门静脉左支1、2 cm间模拟穿刺途径距离均有显著性差异(P<0.01);下等分线与肝门静脉右支1、2 cm间有差异(P<0.05)。结论 64-MSCT能为DIPS术提供活体状态下的相关穿刺信息。DIPS术模拟穿刺途径的研究有助于DIPS术确定穿刺途径和选择支架长度和类型。

Objective To measure related parameters of the puncture channel of simulated direct intrahepatic portacaval shunt（DIPS） adopting 64-Slice spiral CT,and provide clinical guidance.Methods 39 healthy volunteers,and 16 cases with cirrhosis underwent the upper abdomen 64-MSCT scan.The puncture points about 1cm and 2cm under the left and right portal branches,and that connected to intermediate retrohepatic segment of inferior vena cava were measured and scored according to Child-Pugh grades.In order to offer clinical applicable information for DIPS,the smart tracking technology（Smart Prep） were used to scan and further process on the GE ADW4.2 workstations.Results There was no significant difference between healthy volunteers and cirrhosis patients for the internal diameters of the left and right branches of portal vein under Child-Pugh grade.The shortest distance appeared between the left branch of portal vein and inferior caval vein.Conclusions For obtaining puncture parameters,64-MSCT is valuable.This study demonstrates the appropriate length and type of the stents.