前列腺动脉CTA与C臂3D-CT血管成像技术在前列腺动脉栓塞术中的应用价值比较  

Comparison of the application value of prostate artery CTA and C-arm 3D-CT vascular imaging technology in prostate artery embolization surgery

作　　者：林宇佳 曾国斌[2] 廖政贤[1] 廖立安[2] 张国栋 张文 吴兴华 韩淑辉 LIN Yujia;ZENG Guobin;LIAO Zhengxian;LIAO Li'an;ZHANG Guodong;Zhang Wen;WU Xinghua;HAN Shuhui(Interventional Surgery Center,Meizhou People's Hospital,Meizhou,Guangdong 514031,China;Department of Interventional,Meizhou People's Hospital,Meizhou,Guangdong 514031,China)

机构地区：[1]梅州市人民医院介入手术中心,广东梅州514031 [2]梅州市人民医院介入科,广东梅州514031

出　　处：《医药前沿》2024年第5期14-18,共5页Journal of Frontiers of Medicine

基　　金：梅州市社会发展科技计划科研课题(2021B80)。

摘　　要：目的:比较前列腺动脉(PA)的计算机体层血管成像(CTA)检查与C臂三维重建计算机断层扫描(3DCT)血管成像技术在前列腺动脉栓塞术(PAE)中的应用价值。方法:收集2020年1月—2022年6月在梅州市人民医院介入手术室行超选择性PAE的39例患者(前列腺增生17例,前列腺癌22例)的术前PA的CTA检查及术中C臂3D-CT血管成像的影像资料,分为CTA组及3D-CT组。分别对CTA、3D-CT检查出的PA起源、数目及走行判定的准确性进行分析,以超选至PA的DSA造影为标准,评估两种前列腺动脉成像技术对PAE的指导价值。结果:在39例患者的78侧髂内动脉中共超选95支PA并经DSA造影证实,其中CTA共诊断出75支PA,诊出率为78.9%,3D-CT共诊断出92支PA,诊出率为96.8%,两组比较,差异有统计学意义(χ^(2)=21.56,P<0.05)。其中3侧髂内动脉共3支CTA诊断为PA,而3D-CT排除为PA。5侧髂内动脉共5支PA CTA未能显示,而3D-CT可显示;9侧髂内动脉共11支PA:CTA仅能诊断出其起源于髂内动脉,而3D-CT可明确其具体起源位置。CTA对大于0.625 mm的PA可以清楚显示其走行与周围血管的关系,而3D-CT可以显示小于0.625 mm的PA的走行情况并显示前列腺组织的染色及有无周围组织器官的染色情况。结论:C臂3D-CT相比于前列腺动脉CTA在PAE术中能更清楚地显示PA的起源、数目及其走行关系,能更好地指导PAE,而术前CTA作为无创检查亦能为术者提供PA及其周围血管的解剖,为术前PAE评估提供了影像依据。Objective To compare the application value of computed tomography angiography(CTA)of the prostatic artery(PA)and C-arm three-dimensional computed tomography(3D-CT)angiography in prostatic artery embolization(PAE).Methods Imaging data of preoperative PA CTA and intraoperative C-arm 3D-CT angiography of 39 patients who underwent superselective PAE in the interventional operating room at Meizhou People's Hospital from January 2020 to June 2022 were collected.These patients included 17 cases of benign prostatic hyperplasia and 22 cases of prostate cancer.The patients were divided into the CTA group and the 3D-CT group.The accuracy of the origin,number,and course determination of PAs detected by CTA and 3D-CT examinations was analyzed.The guidance value of the two prostatic artery imaging technologies for PAE was evaluated using digital subtraction angiography(DSA)as the standard for superselective PA.Results A total of 95 PAs were superselected and confirmed by DSA angiography among 78 internal iliac arteries in 39 patients.Among them,CTA diagnosed 75 PAs,with a diagnostic rate of 78.9%,while 3D-CT diagnosed 92 PAs,with a diagnostic rate of 96.8%.The difference between the two groups was statistically significant(χ^(2)=21.56,P<0.05).Three internal iliac arteries were diagnosed as PAs by CTA,but excluded as PAs by 3D-CT.Five internal iliac arteries were not displayed by CTA,but were displayed by 3D-CT.For nine internal iliac arteries with 11 PAs,CTA could only diagnose their origin from the internal iliac artery,while 3D-CT could accurately determine their specific origin.CTA could clearly display the course of PAs larger than 0.625 mm and their relationship with surrounding vessels,while 3D-CT could display the course of PAs smaller than 0.625 mm and the staining of prostatic tissue and surrounding organs.Conclusions Compared with prostatic artery CTA,C-arm 3DCT can more clearly display the origin,number,and course relationship of PAs in PAE procedures,providing better guidance for PAE.Preoperative CTA,as a non-inva

关 键 词：前列腺动脉栓塞术 前列腺癌 前列腺增生 CTA C臂3D-CT 

分 类 号：R543.5[医药卫生—心血管疾病]