DSA图像叠加技术辅助肝动脉标记在TIPS术中的应用  

DSA Image Overlay Technology Assisted with Hepatic Artery Mark in Guided TIPS Puncture

作　　者：鞠帅[1] 李姚 李文强 李小燕[1] 董智慧 罗剑钧 JU Shuai;LI Yao;LI Wenqiang;LI Xiaoyan;DONG Zhihui;LUO Jianjun(Department of Vascular and Wound Center,Jinshan Hospital,Fudan University,Shanghai 201508,China;Department of Vascular Surgery,Zhongshan Hospital,Fudan University;Department of Intervention Therapy,Zhongshan Hospital,Fudan University)

机构地区：[1]复旦大学附属金山医院血管和创面中心,上海201508 [2]复旦大学附属中山医院血管外科 [3]复旦大学附属中山医院介入科

出　　处：《中国医学计算机成像杂志》2023年第6期700-703,共4页Chinese Computed Medical Imaging

基　　金：金山区科委(2021-3-05)。

摘　　要：目的:探讨数字减影血管造影(DSA)图像叠加技术辅助肝动脉标记引导在经颈内静脉肝内门体分流术(transjugular intrahepatic portosystemic shunt,TIPS)中门静脉穿刺的应用效果。方法:回顾性分析在我院行TIPS术的患者,并分为超声引导组(超声引导TIPS门静脉穿刺)及新技术组(DSA图像叠加技术辅助肝动脉标记引导TIPS门静脉穿刺)。比较2组门-体分流道穿刺时间、穿刺次数、手术时间以及相关临床指标。结果:48例患者纳人该研究。与超声引导组相比,新技术组的穿刺时间(P<0.001)及手术时间(P=0.018)均明显降低。2组患者术后的天冬氨酸转氨酶、B型脑钠肽及门静脉压力均明显降低。新技术组患者术后的总胆红素(P=0.004)、丙氨酸转氨酶(P=0.022)明显降低。结论:DSA图像叠加技术辅助肝动脉标记能够很好的引导TIPS穿刺门静脉,缩短穿刺及手术时间。Purpose:To investigate the application of digital subtraction angiography(DSA)image overlay technology assisted by hepatic artery mark in guiding transjugular intrahepatic portal systemic shunt(TIPS)puncture.Methods:A retrospective analysis was conducted in patients undergoing TIPS in our hospital.The patients were divided into ultrasound guided group(ultrasound guided TIPS puncture)and new procedure group(DSA image overlay technology assisted by hepatic artery mark guided TIPS puncture).The subjects were compared in terms of portosystemic shun puncture time,puncture times,surgical time,and surgery related clinical indicators.Results:Forty-eight patients were included in the study.Compared with the ultrasound guided group,the puncture time(P<0.001)and surgical time(P=0.018)in the new technology group were significantly reduced.In both groups,postoperative aspartate aminotransferase,B-type natriuretic peptide,and portal vein pressure were significantly decreased.In the new technology group,total bilirubin(P-0.004),alanine aminotransferase(P=0.022)were significantly reduced.Conclusion:DSA image overlay technology assisted by hepatic artery mark can be used to guide TIPS puncture effectively by shortening surgical time and puncture time.

关 键 词：门静脉高压 数字减影技术 图像叠加技术 肝动脉标记 经颈内静脉肝内门体静脉分流术 

分 类 号：R445.3[医药卫生—影像医学与核医学]