MSCT在肝转移瘤介入治疗中的应用价值  

The Applied Value on MSCT in the Interventional Treatment of Hepatic Metastases

作　　者：王志强[1] 李涛[1] 邓平[1] 谭华绣[1] 

机构地区：[1]湘南学院医学影像系,湖南郴州423000

出　　处：《中国现代医生》2009年第18期176-178,共3页China Modern Doctor

基　　金：湖南省教育厅科研项目(项目编号:06C779)

摘　　要：目的探讨MSCT在HMs介入治疗中的应用价值。方法23例HMs行介入治疗。介入治疗前先行MSCT平扫,然后行双期增强扫描及血管重建。结果平扫发现病灶78个;增强扫描于动脉期发现病灶102个、门脉期发现病灶105个。对直径<1cm的病灶检出,动态增强扫描明显优于平扫(P<0.05)。CT表现:平扫表现为类圆形低密度灶;增强扫描按强化病灶数目多少分别表现为边缘环形强化、弥漫性强化、不均匀强化、无强化。血管重建显示情况:所有病例通过MSCTA均能显示3级以下肝动脉,与DSA完全相符,显示率达100%;对4级以上肝动脉显示14例,显示率为60.9%。门静脉显示:所有病例通过MSCTA均能显示4级以下门静脉肝内分支;DSA肝动脉造影可间接显示门静脉,但3级以下肝内分支大都显示不清。结论MSCT动态增强扫描为较常用的影像检查手段,能提高HMs的检出率。动态增强扫描在检出率方面优于平扫,尤其在直径<1cm病灶的检出上有显著差异。通过快速的动态增强扫描能重建出高质量的肝动脉及门静脉血管像,且较DSA在诊断方面具有易操作性和非创性的优势,从而为合理制定HMs介入治疗方案提供重要的指导作用。Objective To discuss the applied value of MSCT in the interventional treatment of hepatic metastases （HMs）. Methods 23 cases HMs were treated by interventional treatment before it MSCT plain scan was performed first,and then dual-phase dynamic contrast-enhanced scanning and reconstruct angiography. Results 78 lesions were found by plain scan,and 102 lesions in the arterial phase and 105 lesions in the portal venous phase were found by contrast-enhanced scan,dynamic contrast-enhanced CT scanning was superior to detecting lesion of diameter 〈lcm （P〈0.05）. CT scanning showed that plain scan showed low-density foci; and according to the number of enhanced lesions,enhancede scanning showed enhancement for the edge of the ring,diffuse enhancement, heterogeneous enhancement,and no enhancement respectly. Vascular remodeling showed that all cases could show the hepatic artery three grade below through MSCTA,completely conformed to the DSA,the indication rate was 100%;14 cases could show the hepatic artery four grade above,with 60.9% indication rate. Portal vein showed that all cases could show the branches of intrahepatic portal vein four grade below through MSCTA; DSA hepatic arteriography could show the portal vein indirectly,but most of the intrahepatic branches three grade below couldn＇t show clearly. Conclusion MSCT dynamic contrast-enhanced scan could improve the detection rate of HMs,and dynamic contrast-enhanced scanning was superior to the detection rate then plain scan,high-qulity imagy of hepatic artery and portal vein could be reconsructed by fast dynamic contrast-enhanced scanning,and compared with DSA,it had the advantage of operat more easily and non-invasive, so as be a guide in the interventional treatment of HMs.

关 键 词：肝转移瘤 介入治疗 体层摄影术 X线计算机 

分 类 号：R459.9[医药卫生—治疗学]