MIP及VR三维重建在原发性肝癌TACE介入前血管系统评估中的应用  

The application of three-dimensional reconstruction in the evaluation of vascular system of primary liver cancer before TACE intervention

作　　者：朱烨晨 耿承军 殷慧康 李亚南 冯权烨 ZHU Ye-chen;GENG Cheng-jun;YIN Hui-kang;LI Ya-nan;FENG Quan-ye(Department of Radiology,Wuxi Taihu Hospital,Jiangsu 214000,China)

机构地区：[1]无锡市太湖医院放射科,江苏214000

出　　处：《肝脏》2023年第5期559-563,共5页Chinese Hepatology

基　　金：无锡市科技发展基金(WX18IIAN041)。

摘　　要：目的探讨最大密度投影(MIP)及容积重建(VR)三维重建在原发性肝癌(PLC)肝动脉化疗栓塞(TACE)介入前血管系统评估中的应用价值。方法选取2020年1月—2022年1月无锡市太湖医院拟行TACE治疗的PLC患者72例纳入研究对象,所有患者治疗前均接受多层螺旋CT(MSCT)及血管造影(DSA)检查,检查结束后通过MIP、VR对MSCT检查获取图像进行三维重建。最后以DSA检查结果为金标准,比较MIP、VR三维重建及DSA中肝动脉分级、肝外动脉、肿瘤供血动脉、肿瘤血管、门静脉分级显示情况。结果1、2级肝动脉显示结果中MIP、VR、DSA显示率均为100%,且显示例数比较未见明显差异(χ^(2)=0.000、0.000,P>0.05);3级肝动脉显示结果中MIP显示69例(95.8%)、DSA显示72例(100.0%)显著高于VR显示的41例(56.9%)(χ^(2)=61.226,P<0.05);4级及以上肝动脉显示结果中MIP显示34例(47.2%)显著高于VR显示的13例(18.1%),而DSA显示的62例(81.6%)显著高于MIP显示的34例(47.2%)(χ^(2)=67.154,P<0.05)。MIP显示腹腔干72例(100.0%)、肠系膜上67例(93.1%)、脾动脉72例(100.0%)、肝总动脉72例(100.0%)、胃十二指肠动脉72例(100.0%)、肝固有动脉72例(100.0%),VR显示腹腔干72例(100.0%)、肠系膜上67例(93.1%)、脾动脉72例(100.0%)、肝总动脉72例(100.0%)、胃十二指肠动脉72例(100.0%)、肝固有动脉72例(100.0%),DSA显示腹腔干72例(100.0%)、肠系膜上69例(95.8%)、脾动脉72例(100.0%)、肝总动脉72例(100.0%)、胃十二指肠动脉72例(100.0%)、肝固有动脉72例(100.0%),三者显示例数比较未见明显差异(χ^(2)=24.376,P>0.05)。MIP显示肿瘤供血动脉70例(97.2%),VR显示肿瘤供血动脉68例(94.4%),DSA显示肿瘤供血动脉72例(100.0%),三者显示例数比较未见明显差异(χ^(2)=4.114,P>0.05);肿瘤血管显示结果中MIP显示63例(87.5%)、DSA显示72例(100.0%)均明显高于VR显示的26例(36.1%)(χ^(2)=87.716,P<0.05)。MIP显示4级门静脉分支70例(97.2%)、5级门静脉分支67例(93Objective To investigate the application value of maximum density projection(MIP)and volume reconstruction(VR)of three-dimentional(3D)reconstruction in vascular system evaluation of primary liver cancer(PLC)before transcatheter arterial chemoembolization(TACE).Methods A total of 72 PLC patients who underwent TACE treatment from January 2020 to January 2022 were selected and included in the study.All patients received multi-slice spiral computed tomography(MSCT)and angiography(DSA)examinations before treatment.The images obtained by MSCT were reconstructed by MIP and VR.Finally,the results of DSA were used as the gold standard to compare the grading of hepatic artery,extrahepatic artery,tumor feeding artery,tumor blood vessel,and portal vein in MIP,VR of 3D reconstruction and DSA.Results The display rates of MIP,VR and DSA in the results of grade 1 and grade 2 hepatic artery display were all 100%,and there was no significant difference in the number of displayed cases(χ^(2)=0.000、0.000,P>0.05);Among the results of grade 3 hepatic artery display,69 cases were shown by MIP(95.8%),72 cases were shown by DSA(100.0%),which were significantly higher than that of 41 cases shown by VR(56.9%)(χ^(2)=61.226,P<0.05).In the results of hepatic artery of grade 4 and above,34 cases(47.2%)displayed by MIP,which were significantly higher than that of 13 cases(18.1%)displayed by VR,and 62 cases(81.6%)displayed by DSA,which were significantly higher than that of 34 cases(47.2%)displayed by MIP.(χ^(2)=67.154,P<0.05).MIP showed celiac trunk in 72 cases(100.0%),superior mesentery in 67 cases(93.1%),splenic artery in 72 cases(100.0%),common hepatic artery in 72 cases(100.0%),gastroduodenal artery in 72 cases(100.0%)),proper hepatic artery in 72 cases(100.0%),celiac trunk in 72 cases(100.0%),superior mesenteric in 67 cases(93.1%),splenic artery in 72 cases(100.0%),and common hepatic artery in 72 cases(100.0%),gastroduodenal artery in 72 cases(100.0%),proper hepatic artery in 72 cases(100.0%),DSA showed celiac trunk in 72 cases(100.0%

关 键 词：原发性肝癌 肝动脉化疗栓塞 最大密度投影 容积重建 三维重建 血管造影 

分 类 号：R735.7[医药卫生—肿瘤]