腹部Xper CT双期扫描联合三维血管重建在TACE术中的应用与价值  

Application and Value of Abdominal Xper CT Double Phase Scan Combined with Three-dimensional Vascular Reconstruction in TACE

作　　者：葛述鑫 陈文倩 张雪斌[1] 曾启龙[1] GE Shuxin;CHEN Wenqian;ZHANG Xuebin(Nanjing Drum Tower Hospital,Nanjing,210009)

机构地区：[1]南京大学医学院附属鼓楼医院,210009

出　　处：《实用癌症杂志》2022年第6期953-955,共3页The Practical Journal of Cancer

摘　　要：目的 探讨TACE术中应用腹部Xper CT双期扫描(Xper CT Abdomen Dual Ph.Roll)技术并进行肝脏血管三维重建(以下简称Xper CT)在发现肝癌病灶和指导临床医生进行超选化疗和栓塞上的价值。方法 收集88例接受TACE治疗的原发性肝癌患者,术中分别行DSA常规造影和腹部Xper CT双期扫描,将术后的碘油CT作为金标准,观察两者发现的病灶数。将88例病例分为实验组和对照组,各44例。实验组进行双期扫描联合三维重建,对照组先行常规DSA造影下尝试超选插管,对比2组准确找到肿瘤供血动脉尝试超选插管所需的次数。结果 所有手术均顺利进行,并行术后碘油CT。碘油CT共显示133个病灶,Xper CT动静脉期发现的病灶高于DSA常规造影(98.4%vs 96.2%);其一次插管成功率高于DSA常规造影(90.9%vs 72.7%),但二次插管成功率较DSA常规造影低(9.1%vs 27.3%)。结论 Xper CT较DSA常规造影能发现更多的原发性肝癌病灶,并能提高一次超选插管的成功率,对指导临床医生进行超选插管进行化疗栓塞有一定价值。Objective To investigate the value of Xper CT dual stage abdominal scan(Xper CT Abdomen Dual Ph.Roll) and three-dimensional reconstruction of liver vessels(hereinafter referred to as Xper CT) during TACE in detecting liver cancer lesions and guiding clinicians to perform superselective chemotherapy and embolization.Methods A total of 88 patients with primary liver cancer who received TACE were enrolled.DSA routine angiography and abdominal Xper CT two-stage scan were performed respectively.Lipiodol CT was taken as the gold standard.The number of lesions found in both groups was observed,and 88 cases were divided into the experimental group and the control group,44 cases in each group.The experimental group underwent two-stage scanning combined with THREE-DIMENSIONAL reconstruction,while the control group tried superselective intubation under conventional DSA angiography first,and The Times required for superselective intubation were compared between the two groups to accurately find the tumor supplying artery.Results All operations were carried out successfully and postoperative CT of lipiodol was performed.Lipiodol CT showed 133 lesions,Xper CT detected more lesions in arteriovenous phase than DSA conventional angiography(98.4% vs 96.2%),and the success rate of primary intubation was also higher than DSA conventional angiography(90.9% vs 72.7%),but the success rate of secondary intubation was lower than DSA conventional angiography(9.1% vs 27.3%).Conclusion Compared with DSA conventional angiography,Xper CT can find more primary liver cancer lesions and improve the success rate of primary superselective intubation,which has certain value in guiding clinicians to perform superselective intubation for chemoembolization.

关 键 词：腹部Xper CT 双期扫描 TACE 超选插管 三维重建 

分 类 号：R730.264[医药卫生—肿瘤]