腹部CT血管成像技术辨识肝癌异位血供在经导管动脉化疗栓塞术前的应用价值  

The application value of abdominal CT angiography in diagnosing the ectopic blood supply of hepatocellular carcinoma before TACE

作　　者：夏水伟 纪建松[1] 卢陈英[1] 涂建飞[1] 杨宏远[1] 舒恩芬 

机构地区：[1]浙江大学丽水医院(温州医科大学附属第五医院),浙江省丽水323000

出　　处：《现代实用医学》2016年第5期569-570,694,F0002,共4页Modern Practical Medicine

基　　金：浙江省科技厅重大科技专项(2013C03010);浙江省中医药科学研究基金计划(2012ZA136)

摘　　要：目的探讨腹部CT血管成像技术(CTA)对肝癌异位血供的诊断价值,旨在改善经导管动脉化疗栓塞(TACE)术的疗效。方法回顾性分析2012年1月至2014年12月收治的300例行TACE术肝癌患者的临床资料,术前均行肝脏增强CT及CTA重建,以DSA为参照标准,分析CTA对肝癌变异动脉供血的显示情况。结果本组300例肝癌患者,符合Michels肝动脉分型共290例,其中Ⅰ型178例,余9型112例;DSA与CTA对照后,CTA准确显示292例,准确率为97.33%。300例肝癌患者中,肝动脉规则供血198例(66.00%),变异性供血102例(34.00%)。结论 CTA能全面、准确的显示肝癌供血动脉的起源、走形及分布,对指导介入TACE有重要价值。Objective To explore the value of the abdominal CTA in demonstrating the ectopic blood supply of hepatocellular carcinoma so as to improve the therapeutic effect of transcatheter arterial chemoembolization（TACE）. Methods Three hundred patients with hepatocellular carcinoma（HCC） underwent enhanced abdominal CT and CTA reconstruction before TACE. With DSA as the reference standard, the accurate rate of CTA in displaying variation of hepatic arteries of hepatocellular carcinoma was analyzed. Results Among 300 HCC patients, there were 290 cases in line with Michels hepatic artery type, of which, including 178 cases of type Ⅰ, another 112 cases belonging to another nine types. Comparing DSA with CTA, CTA accurately showed 292 cases, and the accuracy rate was 97.33%.Among 300 HCC patients, 198（66.00%）cases of hepatic artery blood supply were normal, and 102 cases（34.00%）had variability of blood supply. Conclusions CT angiography can comprehensively and accurately display anatomy of hepatic artery of HCC, which can guide the TACE effectively.

关 键 词：肝癌 变异肝动脉 血管成像 X线计算机 体层摄影术 

分 类 号：R816.5[医药卫生—放射医学]