多层螺旋CT血管显像对胃癌微创靶向治疗的影响研究分析

Research analysis of Multislice CT angiography imaging effect on gastric cancer targeted therapy of minimally invasive

目的研究分析多层螺旋CT血管显像对胃癌微创靶向治疗的临床影响。方法选取胃癌患者60例,采用SIEMENS CT进行不间断容积扫描,区域为膈顶至腹主动脉分叉之间,采用SIEMENS Syng系统进行处理。然后行3D最大密度投影、薄层最大密度投影、模式容积标示分别对动脉期行血管重建,采用薄层最大密度投影行静脉期显像血管重建,按照所得到的血管直径和分布状态进行图像层厚和角度的调整,获得薄层最大密度投影显像,对胃周围动、静脉及癌区的血液供应状态进行分析。结果胃左静脉60例患者中,胃左静脉显像57例(95.0%),胃左静脉均为近胃壁区和胃左动脉相行,术前行MSCT血管显像可有效观察胃左动静脉起点和入点。胃贲门区胃癌27例,供血血管主要为胃左动脉(45.0%),胃窦区胃癌23例,供血血管主要为胃网膜右动脉或胃右动脉(38.33%),胃小弯区胃癌7例,供血血管主要为胃左动脉(11.67%),胃大弯区胃癌3例,供血血管主要为胃网膜左动脉(5.0%)。结论采用多层螺旋CT胃周血管显像中的模式容积标示、最大密度投影,薄层最大密度投影重建方法联合应用,可有效对胃供血动脉的起点等一般情况进行清晰显像,但以上检查对远端细小血管显像较差,适合临床根据患者情况选择应用。

Objective Multislice CT angiography imaging study analysis the clinical impact of minimally invasive tar-geted therapy for gastric carcinoma. Method Select 60 patients with gastric cancer in our hospital between January 2013 and January 2016. Use SIEMENS CT to continuous volume scan the area for roof insulation between abdominal aortic bifurcation;use SIEMENS Syng system for processing. Then the maximum density line 3 d projection Thin lay-er maximum density projection mode volume label line of arterial vascular remodeling,respectively. Maximum density projection line venous phase imaging was used to vascular remodeling,the blood vessel diameter and distribution of received in accordance with the state to adjust image layer thickness and angle,to obtain a thin layer of maximum density projection imaging,arteriovenous and cancer of the blood around the stomach does not understand the sup-ply. Result In this study,left gastric vein of 60 cases,left gastric vein imaging of 57 cases（95. 0%）,left gastric vein are close to the lining of the stomach area and left gastric arterial phase,phase is in the wall of the stomach,with the left gastric artery phase from the line,the other import point,23（38. 33%）of the portal vein,splenic vein 16 （26. 67%）,spleen Angle of 10（16. 67%）. Gastric cardia area of 27 cases of gastric cancer,blood vessels supplying the main for the left gastric artery（45. 0%）,gastric antrum district 23 cases of gastric cancer,main for retinal right gastric artery or blood vessels supplying the right gastric artery 38. 33%,area of gastric small turn 7 cases of gastric cancer,blood vessels supplying the main for the left gastric artery（11. 67%）,stomach big bend area 3 cases of gas-tric cancer,blood vessels supplying the mainly for retinal left gastric artery（5. 0%）. Conclusion The vascular ima-ging patterns in MSCT stomach volume label Maximum density projection,a thin layer of maximum density projection joint reconstruction method is effective for the starting point of stomach blood supply arteries and generally clear ima-ging,but these checks for distal small vascular imaging is poorer, suitable for clinical doctors choose application based on clinical patients.