右膈下动脉64层螺旋CT三维重建在肝癌介入治疗中的应用  

The application of right inferior phrenic artery reconstruction by using 64-slice 3D-MDCT in interventional treatment of hepatocellular carcinoma

作　　者：刘长春[1] 董景辉[1] 安维民[1] 宿贝贝[1] 高原智[1] 李勇武[1] 马威[1] 

机构地区：[1]解放军第302医院医学影像中心,北京100039

出　　处：《中国医学装备》2014年第5期87-89,共3页China Medical Equipment

摘　　要：目的:分析右侧膈下动脉(RIPA)在多层螺旋CT血管三维重建中的表现,探查其解剖与变异在肝癌介入治疗中的作用。方法:回顾性分析935例患者行腹部螺旋CT三维重建的临床资料,采用容积再现(VR)、曲面重组(MPR)和最大密度投影(MIP)3种方法进行血管重建,总结RIPA的起源和分布对经导管动脉栓塞化疗(TACE)的指导意义。结果:935例进行右膈下动脉螺旋CT三维重建的病例均可成功显示膈下动脉起源(占100%),其中发自于双侧膈下动脉共干者为163例(占17.4%),单独发自于RIPA者为772例,其中发自于腹主动脉、腹腔动脉干、右侧肾及副肾动脉、胃左动脉、肠系膜上动脉和肝动脉分别为367(占39.3%)、320例(占34.2%)、196例(占21.0%)、27例(占2.9%)、11例(占1.1%)和14例(占1.5%)。RIPA参与原发性肝癌(HCC)供血者达12.5%(32/255)。结论:螺旋CT三维重建可在介入术前了解右膈下动脉的起源与分布,并判断有无肝癌侧枝供血,对于临床TACE具有指导意义。Objective： To analysis the anatomy and variations of the right inferior phrenic artery（RIPA） in 3D-MDCT reconstruction and discuss the application in interventional treatment ofHCC. Methods： The origin and distribution of RIPAs in 935 cases（628 cases of hepatic cirrhosis, 255 cases of HCC, 52 cases of normal people） were analyzed retrospectively by using volume rendering（VR）, multiplanar reconstruction（MPR） and maximum intensity projection（MIP） to summarize the applications before and after transcatheter arterial chemoembolization（TACE）. Results： The RIPA origin was detected in all cases（sensitivity 100%）. The RIPA and LPIA have the common trunk in 163 cases, and arise separately in other 772 cases. RIPAs originated from the aorta（39.3%）, celiac trunk（34.2%）, right renal artery or accessory renal artery（21.0%）, left gastric artery（2.9%）, superior mesenteric artery（1.1%） and hepatic artery（1.5%）. Thirty-two of 255 cases demonstrate the supplement of HCC. Conclusion： 3D-MDCT reconstruction can be used to recognize the origin and distribution of RIPA and judge the extrahepatic collateral vessels by interventional radiologists before TACE.

关 键 词：右膈下动脉 肝细胞癌 多排螺旋CT 化疗栓塞 

分 类 号：R735.7[医药卫生—肿瘤]