经动脉插管C臂CT灌注扫描在前列腺动脉栓塞术中的临床价值  

The clinical value of transarterial catheterization C-arm CT perfusion scanning during prostatic artery embolization

作　　者：张程智 宋梦瑶 焦德超[1] 韩新巍[1] 刘一铭 许凯豪 ZHANG Chengzhi;SONG Mengyao;JIAO Dechao;HAN Xinwei;LIU Yiming;XU Kaihao(Department of Interventional Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院介入放射科,河南郑州450052

出　　处：《实用放射学杂志》2024年第2期285-288,共4页Journal of Practical Radiology

摘　　要：目的评价经动脉插管C臂CT灌注扫描技术在前列腺动脉栓塞术(PAE)治疗良性前列腺增生(BPH)的临床价值。方法回顾性分析行PAE治疗的46例BPH患者的临床资料,所有患者行前列腺动脉(PA)数字减影血管造影(DSA)及术中插管C臂CT灌注扫描以明确PA,预防非靶器官性栓塞。由3位高级职称协商比较识别PA的准确性。经C臂CT证实后在透视下用100~300μm的聚乙烯醇(PVA)颗粒或栓塞微球栓塞PA,观察术后并发症及术后3个月临床有效率。结果46例患者共造影106支血管,发现PA 83支,非PA 23支。其中DSA发现68支,敏感度81.9%(68/83),C臂CT共确诊83支,敏感度100%(83/83),2组比较差异有统计学意义(χ^(2)=22.3,P<0.01);DSA确诊17支非PA,特异度73.9%(17/23),C臂CT确诊23支非PA,特异度100%(23/23),2组比较差异有统计学意义(χ^(2)=9.2,P=0.02),术后未见严重并发症,术后3个月评价临床有效率91.3%。结论经动脉插管C臂CT扫描技术能准确辨认PA,减少PA漏栓和预防非靶器官误栓。Objective To evaluate the clinical value of transarterial catheterization C-arm CT perfusion scanning technique during prostatic artery embolization(PAE)for benign prostatic hyperplasia(BPH).Methods The clinical data of 46 patients with BPH received PAE were analyzed retrospectively.All patients underwent prostatic artery(PA)digital subtraction angiography(DSA)and C-arm CT perfusion scanning to identify PA and prevent non-target organ embolization.The final recognization of PA was consulted by three senior doctors.After C-arm CT confirmation,PA was embolized with 100-300μm polyvinyl alcohol(PVA)particles or microspheres under fluoroscopy.The postoperative complications and 3-month clinical efficacy were observed.Results A total of 106 vessels were angioraphed in 46 patients,with 83 PA vessels and 23 non-PA vessels.PA was identified by DSA and C-arm CT with sensitivity of 81.9%(68/83)and 100%(83/83),respectively,which showed significance(χ^(2)=22.3,P<0.01).Non-PA was identified by DSA and C-arm CT with specificity of 73.9%(17/23)and 100%(23/23),which showed significance(χ^(2)=9.2,P=0.02).No serious complications were observed and 3-month clincial efficacy was 91.3%.Conclusion Transarterial catheterization C-arm CT perfusion scanning technique can accurately identify PA,reduce PA leakage and prevent non-target organ embolization.

关 键 词：前列腺增生 前列腺动脉栓塞术 C臂CT 灌注成像 

分 类 号：R697.3[医药卫生—泌尿科学] R815[医药卫生—外科学] R814.42[医药卫生—临床医学]