多层螺旋CTA后处理技术在肝胆肿瘤术前可切除性评估中的临床应用

The application of Post Processing Techniques of Multi - slice Helical CT in the preoperative resection e- valuation in hepatic carcinoma and biliary tract carcinoma

目的探讨多层螺旋CT三维血管成像在肝胆肿瘤术前可切除性评估中的临床应用价值。方法采用多层螺旋CT对42例肝胆肿瘤患者进行增强检查，应用多平面重建（MPR）、最大密度投影（MIP）、容积再现（VR）、表面遮盖技术（SSD）以及曲面重建（CPR）等三维重建方法分析肿瘤与邻近血管的CTA表现，对肝胆肿瘤患者进行术前可切除性评估，与术后结果应用Kappa检验进行对照分析。结果手术结果显示42例肝胆肿瘤患者中有6例存在血管浸润，而多层螺旋CTA（MSCTA）结果显示只有2例患者存在血管浸润。两种检查结果行Kappa检验，Kappa值=0．644，表明肝胆肿瘤术前可切除性评估与术后结果一致性较好。结论MSCTA对肝胆肿瘤可切除性进行术前评估，与手术结果有较强的一致性，对临床治疗方案的制定及术后评估具有指导性意义。

Objective To explore the value of multi - slice spiral CT angiography （MSCTA） in the pre- operative resection evaluation in hepatic carcinoma and biliary tract carcinoma. Methods Forty - two patients with hepatic carcinoma and biliary tract carcinoma were involved in this study. The primitive data of arterial phase and portal vein phase were reconstructed by muhiple planar reformation （ MPR）, maximum intensity projection （MIP） ,volume rending（ VR）, shaded surface display（SSD） and curved planar reformation（CPR）. The results of preoperative resection evaluation were compared with the surgical resuhs in Kappa inspection. Results The sur-gical results showed that there were 6 cases with vascular invasion in 42 patients with hepatic and biliary tract car-cinoma. MSCTA results showed that there were just 2 cases with vascular invasion. Compared with the surgical re-sults in Kappa inspection（ Kappa = 0. 644） , it showed that preoperative resection evaluation of MSCT in hepatic and biliary tract tumors have good consistency to the surgical resuhs. Conclusion There is strong consistency between the surgical results and preoperative resection evaluation of MSCT in hepatic and biliary tract tumors. It has guiding significance in clinical treatment and postoperative assessment.