C臂类CT血管成像技术在前列腺动脉栓塞术中的应用价值  

Application value of C-arm CT angiography in interventional embolization of prostate artery

作　　者：林宇佳 曾国斌[1] 廖政贤[1] 张国栋 吴兴华 LIN Yu-jia;ZENG Guo-bin;LIAO Zheng-xian(Interventional Operation Room,Meizhou People's Hospital,Guangdong 514031,China)

机构地区：[1]梅州市人民医院介入手术室,广东514031

出　　处：《放射学实践》2021年第4期541-545,共5页Radiologic Practice

基　　金：梅州市医药卫生科研课题(2018-B-60)。

摘　　要：目的:探讨C臂类CT血管成像技术在前列腺动脉介入栓塞术中的应用价值。方法:2017年9月-2020年1月32例患者(前列腺增生23例,前列腺癌9例)在本院行前列腺动脉栓塞治疗,所有患者在术中行髂内动脉DSA检查,31例行双侧、1例行单侧前列腺动脉超选择性DSA及C臂类CT血管成像检查。由一位影像诊断医师及一位介入手术医师(均为副主任医师及以上职称)对两种检查图像进行分析,比较两种方法对辨认前列腺动脉(PA)的准确性、前列腺的染色情况及吻合支的显示情况等。结果:32例患者共超选择了76支血管,共发现60支PA,16支非靶器官动脉。其中,DSA组共确认50支PA、敏感度为83.3%(50/60),类CT组共确认60支PA、敏感度为100%(60/60),两组间差异具有统计学意义(χ^(2)=10.909,P=0.001);DSA组共确认11支非靶器官动脉(膀胱支、直肠支及会阴支等)、特异度68.8%(11/16),类CT组共确认16支非靶器官动脉、特异度100%(16/16),两组间差异具有统计学意义(P=0.043)。DSA组发现前列腺动脉与邻近动脉间的吻合支8支(13.3%),类CT组发现17支(28.3%),两组间差异具有统计学意义(χ^(2)=4.093,P=0.035)。类CT组可以通过多容积重建技术完整显示整个前列腺的染色情况。结论:在前列腺动脉介入栓塞术中借助C臂类CT血管成像技术可以准确辨认前列腺动脉及其吻合支的情况,减少对前列腺动脉的漏栓,预防非靶器官动脉的误栓,有助于提高前列腺疾病栓塞治疗的效果和降低并发症。Objective:The purpose of this study was to investigate the application value of C-arm CT angiography in interventional embolization of prostate artery.Methods:32 patients(23 cases with benign prostatic hyperplasia and 9 cases with prostate cancer)underwent prostate artery embolization in the interventional operating room of our hospital from September 2017 to January 2020.All patients underwent internal iliac artery DSA examination,31 patients underwent bilateral and one patient underwent unilateral prostatic artery superselective DSA and C-arm CT angiography.The images of the two groups were reviewed by a senior radiologist specialized in imaging diagnosis and an interventional surgeon.The accuracy of the two methods in identifying the prostate artery(PA),prostate staining degree and anastomotic branches were compared statistically.Results:In the 32 patients,super-selective catheterization was performed in 76 vessels,including 60 PAs and 16 non-target vessels.Among them,50 PAs were confirmed in DSA group with a sensitivity of 83.3%(50/60);60 PAs were confirmed in CT group with a sensitivity of 100%(60/60).The difference was statistically significant(χ^(2)=10.909,P=0.001).11 non-target vessels(supply artery of bladder,rectum and perineum)were confirmed in group A,the specificity was 68.8%(11/16),and the specificity of CT group was 100%(16/16).The difference between the two groups was statistically significant(P=0.043).Eight(13.3%)anastomotic branches between prostatic artery and adjacent arteries were found in DSA group,and 17(28.3%)anastomotic branches were found in CT group,the difference was statistically significant(χ^(2)=4.093,P=0.035);C-arm CT angiography could display the staining of the whole prostate through multi-volume reconstruction technique.Conclusion:C-arm CT imaging can accurately identify the prostate artery and its anastomotic branches,reduce the omission embolization of the anastomotic branches,prevent false embolization of non-target artery,thus is helpful to improve the effect of embolizati

关 键 词：前列腺动脉 介入栓塞术 C臂CT 数字减影血管造影 

分 类 号：R814.43[医药卫生—影像医学与核医学] R814.42[医药卫生—放射医学]