旋转数字减影血管造影三维重建在肝癌介入治疗中的应用研究

Application study on three dimensional reconstruction of rotational digital subtraction angiography in interventional treatment for hepatocellular carcinoma

目的探讨旋转数字减影血管造影(DSA)三维重建在肝癌介入治疗中的应用价值。方法选取复旦大学附属上海市第五人民医院收治的104例行介入治疗的肝癌患者作为研究对象,按照检查方式的不同分为三维组(行旋转DSA三维重建)和常规组(常规DSA),对两种检查方法下病灶的显示效果及手术疗效等进行回顾性对比分析。结果与常规组相比,三维组的碘油沉积完全率、超选择动脉插管成功率更高(96.30%vs 72.00%,94.44%vs 76.00%),手术时间更短[(32.62±5.42)min vs(44.24±6.53)min],P<0.05。两组的造影剂用量、肿瘤供血动脉显示率比较,差异无统计学意义(P>0.05)。相比常规组,三维组的甲级片占比更高(92.59%vs 68.00%),肿瘤侧支循环显示率(50.00%vs 24.00%)、小病灶显示率(25.93%vs 6.00%),小病灶供血动脉显示率(25.93%vs 6.00%、小病灶侧支循环显示率(31.48%vs 0)和肝动脉3/4级检出率更高(96.30%vs 68.00%),差异均有统计学意义(P<0.05)。三维组的总缓解率为70.37%,明显高于常规组的44.00%,P<0.05。结论在肝癌介入治疗中采用旋转DSA三维重建技术能够提高图像质量,同时缩短手术时间,提高手术效果。

Objective To investigate the application value of 3D(three-dimensional)reconstruction of rotational digital subtraction angiography(DSA)in interventional treatment for hepatocellular carcinoma(HCC).Methods One hundred and four patients with HCC treated by interventional therapy in our hospital were selected,they were divided into 3D group(3D reconstruction by rotational DSA)and conventional group(conventional DSA)according to different examination methods.The display effect on lesions and the surgical effect of the two examination methods were retrospectively analyzed.Results Compared with the conventional group,the lipiodol deposition rate and the success rate of superselective arterial catheterization in the 3D group were higher(96.30%vs 72.00%,94.44%vs 76.00%).The operation time of 3D group was shorter[(32.62±5.42)min vs(44.24±6.53)min],P<0.05.There was no significant difference in the amount of arterial contrast agent and the display rate of tumor blood supply arteries between the two groups(P>0.05).Compared with the conventional group,the first film rate(92.59%vs 68.00%)and the detection rate of hepatic artery grade 3/4(96.30%vs 6.00%)in the 3D group were higher.The display rate of tumor collateral circulation(50.00%vs 24.00%),small lesions(25.93%vs 6.00%),blood supply artery of small lesions(25.93%vs 6.00%)and collateral circulation of small lesions(31.48%vs 0)in the 3D group were higher than those of the conventional group.The differences were all statistically significant(P<0.05).The total remission rate of 3D group was 70.37%,which was significantly higher than that of conventional group(44.00%,P<0.05).Conclusion In the interventional treatment of liver cancer,3D reconstruction technology of rotational DSA can improve the image quality,shorten the operation time and improve the operation effect.