3D-DSA在微细血管供血肝癌的介入治疗中应用价值

The value of 3D-DSA in the interventional treatment of the liver cancer supplied by the micro-vascular blood

目的:探讨3D-DSA(digital subtraction angiography three-dimensional image reconstruction)技术在微细血管供血的肝癌介入治疗中应用价值。方法:2015年8月-2018年8月间在我院就诊的介入术中二维DSA减影证实为微细血管供应的肝癌患者微细血管供血肝癌患者60例,采用随机数字表法均分为两组;2D组(30例)采用传统的二维透视下寻找供血动脉,3D组(30例)采用旋转血管造影(Rotational Angiography)技术,观察肝癌微细供血动脉的开口、解剖形态。比较两组患者术中操作时间、曝光剂量、对比剂用量、术后病灶碘油充填情况。结果:2D、3D两组介入操作时间分别为(83.67±22.04)min、(75.57±14.37)min(P>0.05);曝光剂量分别(2290±640.36)mGy、(996.4±342.86)mGy(P<0.01);对比剂用量分别为(167.73±52.82)ml、(92.90±29.79)ml(P<0.01),术后首次随访碘油填充情况(Ⅰ+Ⅱ)分别为24例、27例(P>0.05)。结论:三维DSA能清晰显示肝癌供血动脉开口位置及解剖形态,明显降低曝光剂量、对比剂用量,是传统二维DSA的有益补充。

Objective To study the value of 3D-DSA in the liver cancer supplied by the micro-vascular blood.Methods From August 2015 to August 2018,60 cases of hepatocellular carcinoma patients admitted to our hospital with two-dimensional DSA subtraction during interventional surgery were confirmed to be hepatocellular carcinoma patients supplied by microvessels.By using random number table,the patients were divided into two groups:2D group (30cases) to find the feeding artery by traditional 2D perspective,3D group (30cases) to observe the opening of the feeding artery of hepatoma and morpho-anatomy by rotational angiography (Rotational Angiography) technology.The duration operation,exposure dose,the amount of contrast agent and the type of lesions iodized oil deposit lipoid were compared between the two groups.Results The operation time between group 2D and group 3D respectively were (83.67±22.04) min and (75.57±14.37)min (P>0.05),exposure dose (2290±640.36) mGy and (996.4±342.86) mGy (P<0.01),amount of contrast agent (167.73±52.82) ml and (92.90±29.79) ml (P<0.01).The type of iodized oil deposit after the first postoperative follow-up (Ⅰ + Ⅱ) were 24 cases,27 cases (P>0.05).Conclusion 3D-DSA can clearly show the location and anatomy of liver cancer artery opening,and significantly reduce the exposure dose,the amount of contrast agent,is a useful complement to traditional two-dimensional DSA.