术前多层螺旋CT血管造影对肺癌支气管动脉灌注化疗的作用

The role of multislice CT angiography preoperative bronchial arterial bronchial artery infusion chemotherapy for lung cancer

目的探讨多层螺旋CT血管造影(CTA)对肺癌支气管动脉灌注化疗的作用。方法回顾性分析61例经病理证实的原发性肺癌患者的影像学资料,28例患者(CTA组)支气管动脉灌注化疗前均进行多层螺旋CT胸部增强扫描,分别采用容积显示(VR)、最大密度投影(MIP)、多平面重建(MPR)等方法进行后重建处理,观察分析支气管动脉形态特征以指导手术操作,33例患者(无CTA组)支气管动脉灌注化疗前未行多层螺旋CT增强检查;比较2组患者术中对比剂用量、术中所用透视时间、手术所用时间的差异。结果 CTA组28例患者中24例术前明确肺癌供血动脉的起源、开口、走行及分布,与数字减影血管造影技术(DSA)造影显示的肿瘤供血动脉的来源分布基本一致,符合率100%;CTA组平均对比剂用量(44±7)mL,平均透视时间(12.3±2.2)min、平均手术时间为(42±11)min;而无CTA组3项数值分别为(74±21)mL、(26.6±5.3)min、(56±10)min。2组患者术中对比剂用量、术中所用透视时间、手术所用时间均有统计学意义(P<0.01),且CTA组明显小于无CTA组。结论 CTA术前能明确支气管动脉等供血动脉解剖,术中明显缩短供血动脉的查找时间,从而减少手术时间、透视时间,减少术中对比剂用量和医患的辐射。CTA对肺癌支气管动脉灌注化疗有指导意义。

Objective To evaluate the clinical value of applications muhislice CT angiography （MSCTA） to the bronchial artery （BA） chemotherapy in primary lung cancer. Methods A retrospective analysis was performed in 61 patients with pathologically provencal primary lung cancer, 28 patients （CTA group） underwent chest enhanced CT scan before bronchial arterial infusion ehemotherapy,MSCTA of tumor supplying artery was performed; with volume rendering （VR）, maximum intensity projection （MIP）, multiplanar reconstruction （MPR） and other methods of reconstruction, BA morphology observed and analysis;33 patients （un-CTA group） were not enhanced CT examination before bronchial artery infusion. Results Twenty-four cases of CTA group definitude the lung cncer feeding arteries origin, opening, running and distribution before operative, and the result basically identical with the DSA angiography ;the ratio is 100%; CTA group, the average amount of contrast agent was （44±7）mL, Average fluoroscopy time was （12.3±2.2）min, mean operative time was （42±11 ）min; the un- CTA group＇ values were （74±21）mL, （26.6 ±5.3 ）min, （56±10）min. Two groups of patients in the amount of contrast medium, fluoroscopy time used for surgery, operation time are statistically significant （P〈0.01）, and CTA group is significantly less than un-CTA group. Conclusion The multi-slice CT angiography can clearly show the bronchial artery dissection, the artery search time on operation is significantly shortened, thereby reducing the operative time, fluoroscopy time, and the amount of contrast agent ;also reducing radiation of the operator and patients. CTA has instructive effeetion on bronchial arterial infusion chemotherapy for lung cancer.