Xper-CT与CTPV融合图像在经颈静脉肝内门腔静脉内分流术中的应用  

Application of fusion imaging combined Xper-CT with CTPV in transjugular intrahepatic portosystemic stent shunt

作　　者：周建峰[1] 靳勇[1] 

机构地区：[1]苏州大学附属第二医院介入放射科,江苏苏州215004

出　　处：《中国医学影像技术》2018年第1期109-112,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价利用Xper-CT与CT门静脉造影(CTPV)融合图像作为经颈静脉肝内门腔静脉内分流术(TIPS)中三维路径图的可行性。方法收集门静脉高压症患者37例,其中21例接受常规TIPS术患者,另16例接受3D路径图下引导TIPS,采集动静脉期和门静脉期图像,对3D路径图下引导TIPS患者在肝脏部位行Xper-CT扫描,在三维工作站中利用"Multi-Modality Matching"功能进行两者图像融合,作为实时透视过程中的三维路径图。结果 Xper-CT与CTPV在融合过程中,骨性对位误差均<2.00mm;术中门静脉CTPV图像与透视的图像的匹配误差稍大,其中15例上下误差>2.00mm,1例左右误差>5.00mm。结论将Xper-CT与CTPV的融合图像作为TIPS的三维路径图,可在不使用对比剂的情况下,术中多角度观察穿刺针与门静脉的位置关系,提高穿刺的定位准确性和安全性,减少手术时间。Objective To explore the feasibility of fusion image of Xper-CT and CT portal venography （CTPV） as DSA 3D-roadmap in operation of transjugular intrabepatic portosystemic stent shunt （TIPS）. Methods Thirty-seven patients with portal hypertension were enrolled in this study, among them 21 underwent conventional TIPS retrospectively, 16 underwent Xper-CT and CTPV imaging to obtain fusion image in the workstation with the software of Multi-Modality Matching for hepatic portal vein without contrast medium administration. Then the fusion image was used as the 3D- roadmap in the process of real-time fluoroscopy. Results In the fusion process of Xper-CT and CTPV, osseous registration error was 〈2.00 mm, while error of the portal vein fusion image and the real-time X-ray image displacement were 〉2.00 mm between up and down in 15 patients, 〉5.00 mm between left and right in 1 patient. Conclusion Xper-CT with CTPV fusion image can be used as 3D-roadmap of TIPS to observe the relationship between puncture needle and the portal vein without administration of contrast medium, improving the accuracy and safety of puncture and reducing operation time.

关 键 词：门体分流术 经颈静脉肝内 门静脉造影术 图像融合 

分 类 号：R654.3[医药卫生—外科学] R814.42[医药卫生—临床医学]