64排螺旋CT三维血管成像在肝细胞癌诊治中的应用

The Application of Three-Dimensional Angiography in Diagnosis and Treatment of the Hepatic Cellular Carcinoma With 64-Detector Row Helical CT

目的:探讨64排螺旋CT三维血管成像在肝癌诊治中的应用价值。方法:用64排螺旋CT对2009年11月-2011年8月笔者所在医院63例肝细胞肝癌患者进行全肝增强三期扫描,使用最大密度投影(MIP)和容积再现技术(VR)对肝脏血管进行三维重建血管成像,并与术中探查对照,总结其治疗方式、患者术中及术后恢复情况。结果:三维重建可清楚显示肝血管形态及其与肿瘤的关系,同时发现MIP重建效果优于VR,但VR能更全面有效地显示空间关系。同时依据检查结果,行介入治疗5例,手术治疗58例,其中肝癌切除术13例,规则性半肝切除术45例。CT所见均经术中证实,且患者术中无大血管分支损伤,术后恢复良好。结论:64排螺旋CT三维血管成像在肝细胞肝癌术前评估能有效显示血管影像,有利于治疗方案的制定和手术的成功。

Objective ：To investigate the application of three-dimensional angiography with 64-detector row helical CT in the diagnosis and treatment of the hepatic cellular carcinoma （HCC）.Methods ：Sixty-three patients with HCC from Nov 2009 to Aug 2011 in our hospital underwent the CT scan of the abdomen with hepatic angiography by maximum intensity projection （MIP） and volume rendering （VR）.Results ：The morphologic structure of the hepatic vessels and their relationship with tumors was displayed well with three-dimensional hepatic angiography. By comparing, the effectiveness of MIP was superior to the VR but the later one could provide a more comprehensive space imaging about the relationship between the tumors and the vessels. Moreover, according to the radiological results, intervention therapy was performed for 5 patients and surgery was carried out for 58 individuals with 13 receiving tumor resection and 45 undergoing regular hepatectomy. All detection by CT scan was confirmed in operation and all patients obtained preferable intraoperative process and postoperative recover. Conclusion ：Preoperative three-dimensional angiography with 64-detector row helical CT could effectively reveal the hepatic vessel imaging, beneficial to the treatment making and surgery success.