二维彩色编码DSA技术评估经导管动脉化疗栓塞最佳状态的价值  

Objective assessment of the endpoint of transcatheter arterial chemoembolization using color-coded digital subtraction angiography

作　　者：王嵇[1] 管逊 赵亮[1] 张学彬[1] 许建荣[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,200127

出　　处：《中华放射学杂志》2014年第9期758-761,共4页Chinese Journal of Radiology

基　　金：上海市重点学科建设项目（S30203）;上海交通大学医学院重点学科项目[重点学科（第三期）];上海市科委国际科技合作基金（12410708300）

摘　　要：目的 探讨采用二维彩色编码DSA技术评估经导管动脉化疗栓塞最佳状态的价值.方法 回顾性分析确诊为肝癌,接受经导管动脉化疗栓塞术（TACE）治疗,并采用二维彩色编码DSA（2D-ccDSA）技术进行后处理的24例患者.患者TACE术前、后均行DSA检查,采用DSA彩色编码软件生成二维彩色编码图像和时间密度曲线（TDC）.测量导管口、肿瘤供血动脉起点和供血动脉栓塞部位以及肿瘤的达峰时间（TTP）,肿瘤血供时间和肿瘤区域TDC最大峰值,并计算栓塞术后肿瘤血供延迟时间.TACE术前、后各参数值的比较采用配对t检验.结果 TACE前导管口和肿瘤供血动脉起点的TTP分别为（3.47 ±0.96）和（4.09±1.09）s,TACE后上述位置的TTP分别为（3.49±1.02）和（3.78±1.05）s,差异无统计学意义（t分别为0.10和1.15,P值分别为0.92和0.26）.TACE前、后供血动脉栓塞部位的TTP分别为（4.62±1.16）和（5.59±1.57）s,肿瘤血供时间分别为（0.52±0.41）和（1.82±1.10）s,峰值分别为（3.03±0.88）和（1.10±0.67）灰度单位,差异均有统计学意义（t分别为3.32、6.04和8.93,P均＜0.01）.栓塞术后肿瘤血供延迟时间为（1.30±1.05）s.结论 二维彩色编码DSA技术可为TACE术最佳状态提供客观且可行的测量指标.Objective To objectively evaluate the endpoint ot transcatheter arterial chemoembolization （TACE） using two dimensional color-coded digital subtraction angiography （2D-ccDSA）.Methods Retrospective analysis of twenty-four patients diagnosed with hepatocellular carcinoma （HCC）,treated by TACE and evaluated by post-processed 2D-ccDSA.All patients were examined by DSA before and after TACE procedure,all these DSA series were converted into color-code images,the time density curve （TDC） was derived from the 2D-ccDSA imaging.Time-to-peak （TTP） was measured for the ostia of the catheter,the origin of the tumor feeding artery （TFA） and the embolized site of the TFA; maximal TDC enhancement was measured for selected spots of the tumor parenchyma.The tumor blood supply time （TBST） for pre and post-TACE was calculated accordingly.Data were interpreted with paired t test using SPSS.Results The TTP of the ostia of the catheter and the origin of the tumor feeding artery （TFA） before TACE were （3.47 ± 0.96） and （4.09 ± 1.09） s,after the TACE were （3.49 ± 1.02） and （3.78 ± 1.05） s,respectively.There was no statistical difference between the pre-and post-procedural TTP of the two landmarks （t values were 0.10 and 1.15,P values were 0.92 and 0.26）.TTP at the embolized site of the main TFA were [（4.62± 1.16） and （5.59± 1.57）s]for pre and post-TACE,the tumor blood supply time （TBST） was greatly delayed compared with that after the TACE procedure [（1.82± 1.10）s and （0.52±0.41）s].The mean maximal TDC enhancements of the tumor parenchyma areas were （3.03±0.88）units before TACE and （1.10±0.67）units after TACE.The differences were all statistically significant （t values were 3.32,6.04 and 8.93,respectively,P＜0.01） Conclusion It is feasible to use 2D-ccDSA to objectively assess the endpoint of TACE procedures.

关 键 词：肝肿瘤 血管造影术 数字减影 放射学 介入性 

分 类 号：R735.7[医药卫生—肿瘤]