MDCT三维血管重建在原发性肝癌TACE治疗中的应用  

The application of MDCT three-dimensional vascular remodeling in the TACE treatment of primary hepatocellular carcinoma

作　　者：涂强[1] 刘勇[2] 吴飞 彭德新[1] 

机构地区：[1]江西省肿瘤医院肝肿瘤诊断治疗中心,南昌330029 [2]江西省九江市第一人民医院介入科,九江332000 [3]江西省九江市第三人民医院介入科,九江332000

出　　处：《江西医药》2016年第11期1133-1135,共3页Jiangxi Medical Journal

基　　金：江西省卫生计生委科技计划;编号:20141738

摘　　要：目的探讨多层螺旋CT(MDCT)三维血管重建在原发性肝癌TACE介入中的应用价值。方法对79例原发性肝癌患者行MDCT增强扫描,并在CT工作站采用最大密度投影(MIP)、容积成像(VR)进行动脉期三维血管重建后再进行介入TACE治疗,观察肝动脉起源、走行变异以及肝外供血动脉情况,并与TACE中造影情况进行对比。结果 79例患者经动脉期三维重建后均可显示肝动脉分支及其起源,其中VR重建对2级肝动脉分支以内的动脉显示良好,且可显示供血动脉起源,MIP重建对肝内的3、4级肝动脉及肿瘤供血动脉显示良好;16例患者存在肝动脉变异,11例具有肝外供血,与TACE术中造影结果一致。结论通过MDCT三维血管重建技术可以初步了解肝癌患者的血管走行及变异,为TACE术中超选择插管提供便利,并可减少血管造影次数,减少对比剂用量,减少医患辐射剂。Objective To investigate the feasibility and accuracy of multidetector computed tomography（MDCT） three-dimensional vascular remodeling for assessment of subsegmental tumor-feeding vessels in transarterial chemoembolization（TACE） of primary hepatic carcinoma（PHC）. Methods A total of 79 PHC patients who underwent TACE were enrolled,they underwent contrast-enhanced MDCT before TACE and observed the hepatic artery origin,anatomic variation and extrahepatic feeding arteries using maximum intensity projection（MIP） and volume-rendering technique（VR） in a CT workstation. Results The branch of hepatic artery and its origin was detected in all cases,while second-order branches of hepatic artery and origin of hepatic artery were display well in VR image,third and fourth-order branches of hepatic artery and tumor feeding arteries were display well in MIP image;the anatomic variation of hepatic artery was found in 16 patients,furthermore,there were 11 patients who had extrahepatic feeding arteries;All the results consistent with the results of DSA imaging. Conclusion MDCT three-dimensional vascular remodeling can provide preliminary image of PHC feeding arteries and its variation that should be facilitate the superselective catheterization to TACE,reduce frequency of angiography,reduce the dosage of contrast medium,and reduce the radiation dose to physician and patient.

关 键 词：原发性肝癌 肝动脉化疗栓塞 三维血管重建 

分 类 号：R735.7[医药卫生—肿瘤]