Dyna-CT引导非血管介入诊疗的价值  

The value of Dyna-CT in the clinical non-vascular intervention

作　　者：刘碧玉[1] 刘战胜[1] 黄得校[1] 林意群[2] 

机构地区：[1]南方医科大学南方医院影像中心,广东广州510515 [2]南方医科大学生物医学工程学院,广东广州510515

出　　处：《中国临床医学影像杂志》2008年第7期498-501,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨与数字平板DSA结合的旋转断层重建技术(Dyna-CT)在非血管介入诊疗过程中的引导价值。方法:对127例非血管介入诊疗的病人进行重建Dyna-CT检查。通过多平面重建进行图像后处理获得Dyna-CT图像。其中男85例,女42例,年龄14～79岁,平均48.5岁。结合透视完成骨关节和软组织的穿刺和治疗,腔道系统(气管或食道)的支架置入术。根据检查部位分为:骨关节57例(脊柱36例,颌面部11例,肩关节6例,髋关节4例),软组织41例(肝脏28例,盆腔6例,腹膜后肿块5例,肾脏2例),腔道29例(气管20例,食道9例)。结果:127例Dyna-CT图像,能成功引导介入手术的104例,成功率为82%。23例失败,占18%。失败原因为:病变与周围组织密度相差太小11例,病人屏气不好造成移动伪影9例,碘油及支架的高密度伪影3例。其中骨关节部位成功54例,占95%。软组织成功26例,成功率为63%。腔道系统成功24例,成功率为83%。经统计学处理3组间有显著性差异(P=0.036),表明Dyna-CT在骨关节系统成功率较高。结论:Dyna-CT可以建立断面图像,更好的满足临床非血管介入诊疗过程的要求。Objective： To investigate the application and of CT-like images created by digital plate DSA combined with rotating tomography reconstruction （Dyna-CT） in the clinical diagnosis and treatment of non-vascular intervention. Methods： One hunderd and twenty-seven cases （85 male and 42 female） were examined by Dyna-CT in the non-vascular interventional procedures, and the Dyna-CT images were gained mainly through muhiplanar reconstruction in the post-processing. In this study, the age ranged from 14 to 79 years old and the average age was 48.5 years. The puncture and treatment for osteoarticular part and soft tissue, in addition to stenting for hollow viscera （trachea or esophagus） had been completed under DSA fluoroscopy and Dyna-CT imagings. According to the different parts of examination, the patients were divided into groups A, B, C. Fifty-seven cases included in the osteoarticular group（group A）, including 36 cases of spinal diseases（n=36）, maxillofacial region diseases（n=ll）, shoulder（n=6） and hip diseases（n=4）. Forty-one cases of soft tissue diseases were included in group B, including liver（n=28）, pelvic（n=5）, retroperitoneal tumor（n=5）, kidney（n=2）. Twenty-nine cases were included in the hollow vis- cera group（group C）, including trachea（n=20）, esophagus（n=9）. Results： Among the 127 cases of non-vascular reconstructional images, 104 Dyna-CT images successfully guide the interventional operation, accounting for 82%. The failure happened in 23 （18%） cases, due to the high density of lipiodol（n=3）, too little density difference between the lesions and the surrounding tissue（n=11）; the patients＇ bad breath hold （n=9）. In this study, there were 54 successful cases in group A, accounting for 95%, and 26 cases in group B, accounting for 63%, and 24 cases in group C, accounting for 83%. There were significant difference in （P〈0.05） these three groups. Conclusion： Dyna-CT can provide sectional view and be obviously meet the nee

关 键 词：放射摄影术 介入性 血管造影术 数字减影 

分 类 号：R814.43[医药卫生—影像医学与核医学]