C形臂CT在精准前列腺动脉栓塞术中的应用

The application of C-arm CT scan in performing precise prostatic arterial embolization

目的探讨C形臂CT在精准前列腺动脉栓塞术(PAE)中的应用。方法通过术中同步动脉造影Xper CT识别前列腺优势动脉及其与周围血管的空间关系,实施精准PAE术。结果 16例良性前列腺增生患者中1例因术中造影发现腹主动脉瘤而放弃手术,2例因一侧髂内动脉闭塞作单侧PAE术,13例成功实施双侧PAE术。所有实施栓塞血管均成功进行Xper CT检查,通过前列腺腺体对比剂染色及腺体周围动脉三维重建确认了前列腺优势动脉及其与周围血管的空间关系,并进行精准PAE术。术后未出现异位栓塞相关并发症,术后1个月临床症状缓解率为100%。结论 PAE术中C形臂CT可为精确识别前列腺动脉及其与周围血管关系提供更确切的影像学图像,是实施精准介入手术的重要技术保障。

Objective To discuss the application of C-arm CT scan in performing precise prostatic arterial embolization （PAE）. Methods The dominant artery of the prostate and its spatial relationship with the peripheral blood vessels were identified by intraoperative synchronous XperCT angiography, which was followed by the performance of precise PAE. Results Among 16 patients with benign prostatic hyperplasia, one patient had to give up the operation because abdominal aortic aneurysm was found by intraoperative angiography; 2 patients received unilateral precise PAE as contralateral internal iliac artery was occluded; bilateral precise PAE was successfully accomplished in 13 patients. XperCT angiography was successfully performed for all the arteries that were treated with embolization. Based on the contrast agent staining of the prostate gland and the 3D reconstruction of peripheral arteries, the dominant artery of the prostate and its spatial relationship with the peripheral blood vessels were determined, and precise PAE was carried out. After PAE, no ectopic embolism-related complications occurred. One month after PAE, the remission rate of clinical symptoms was 100%. Conclusion Intraoperative C-arm CT scan can provide more accurate images which are very important for accurately identifying the prostate arteries and its relationship with the peripheral vessels, therefore, C-arm CT scan is an important technical support for the performance of precise PAE.