基于CBCT的三维重建技术在原发性肝癌TACE治疗中的应用  

The Application of 3D Reconstruction Technology Based on CBCT in the TACE Treatment of Primary Liver Cancer

作　　者：谢宝杰[1] 朱丽娜[1] 张凤娟[1] 王秋香[1] 李智岗[1] 

机构地区：[1]河北医科大学第四医院放射科,石家庄050011

出　　处：《基因组学与应用生物学》2017年第9期3616-3621,共6页Genomics and Applied Biology

基　　金：河北医科大学第四医院资助

摘　　要：为了深入了解基于CBCT的三维重建技术在原发性肝癌TACE治疗中的应用,本研究对在我院进行TACE治疗的原发性肝癌患者,分别采用基于CBCT的三维重建技术和常规的DSA技术进行分析比较。我们选取我院2013年1月~2015年10月确诊的67例原发性肝癌患者,采用随机数字表法分为CBCT组34例、血管造影(DAS组)33例,两组均采用TACE治疗,术中分别给予CBCT及三维重建、DSA技术进行手术指指导。研究表明:CBCT组对肿瘤供血动脉检出正确率、超选择动脉插管成功率、碘油在病灶中完全沉积率均高于DSA组(p<0.05);CBCT组的手术时间、辐射总剂量均高于DSA组(p<0.05);术后一个月复查,CBCT组CR 17.65%、PR 73.53%、SD 8.82%,DSA组CR 6.06%、PR 66.67%、SD 21.21%、PD 6.06%,两组比较差异具有统计学意义(p<0.05);术后一个月复查,CBCT组血清AFP水平低于DSA组(p<0.05);两组患者的KPS评分较本组术前均显著的提高(p<0.05),两组间的KPS评分差异无统计学意义(p>0.05)。我们的研究初步得出结论:基于CBCT的三维重建技术在原发性肝癌TACE治疗中较DSA技术能够更好的检出肿瘤的供血动脉、指导手术更加便捷和精确,能达到更好的手术效果。In order to further understand the application of 3D reconstruction technology based on CBCT in the transcatheter arterial chemoembolization（TACE） treatment of primary liver cancer,the patients suffered from primary liver cancer who had received TACE treatment in our hospital were analyzed and compared by 3D reconstruction operation based on cone beam CT（CBCT） and conventional DSA technique.We selected 67 patients with primary liver cancer diagnosed in our hospital from January 2013 to October 2015,and divided them into CBCT group of 34 cases and angiography（DAS group） of 33 cases by random number table method.Both groups received TACE treatment,but one group received CBCT and 3D reconstruction and the other received DSA technology during the operation as constructions.The results showed that the detection accuracy rate of the tumor feeding artery,success rate of super selective arterial intubation,and the complete deposition rate of iodine oil in the lesions of CBCT group were all higher than those of DSA group（p〈0.05）.Operation time and total radiation dose of CBCT group were higher than those of DSA group（p〈0.05）.The check in one month after surgery showed that the CR,PR and SD of CBCT group were 17.65%,73.53% and 8.82%,respectively,but for DSA,PRwas 66.67%,SD was 21.21%,PD and CR were both 6.06%.The differences between the two groups had no statistical significance（p〈0.05）.The check in one month after surgery demonstrated that serum AFP level of CBCT group was lower than that of DSA group（p〈0.05）.The KPS scores of the two groups were obviously higher than before（p〈0.05）,while the difference in KPS score between the two groups was not statistically significant（p〉0.05）.In conclusion,our study preliminarily summarized that the 3D reconstruction technique based on CBCT could detect the blood supply artery of tumor better than DSA technology in TACE treatment of primary liver cancer.It could guide the operation to be more convenient and accurate,so as to achieve bett

关 键 词：肝动脉栓塞化疗 锥形束CT 三维重建 原发性肝癌 

分 类 号：R730.44[医药卫生—肿瘤] R735.7[医药卫生—临床医学]