64排螺旋CT多平面重建在CT引导下经皮肝穿刺活检中的应用价值  

Application value of 64-slice spiral CT with multiplanar reconstruction in CT-guided percutaneous liver puncture for biopsy

作　　者：王立学 黄渤琪 王栋 关颖 曹娜 WANG Lixue;HUANG Boqi;WANG Dong(Department of Imaging,Qinhuangdao Fourth Hospital,Hebei,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第四医院影像科,066000

出　　处：《河北医药》2024年第19期2974-2977,共4页Hebei Medical Journal

基　　金：秦皇岛市重点研发计划科技支撑项目(编号:202301A163)。

摘　　要：目的探究64排螺旋CT多平面重建在CT引导下经皮肝穿刺活检的应用价值。方法选择2020年1月至2022年12月肝脏病变穿刺52例患者作为研究对象,采用随机数字表法分为MPR重建图像参照组(n=26)与轴位图像参照组,每组26例。轴位图像参照组使用常规轴位图像定位,MPR重建图像参照组患者的容积数据进行轴、矢、冠多方位重建,指导穿刺进针轨迹、取材的部位。比较2组患者术中调整进针方向的次数、取材的准确性、术后并发症、穿刺时间、穿刺成功率、术后疼痛。结果MPR重建图像参照组术中调整进针方向的次数、穿刺时间少于轴位图像参照组,术后疼痛评分低于轴位图像参照组(P<0.05)。MPR重建图像参照组取材的准确性、穿刺成功率高于轴位图像参照组,但组间比较无明显差异(P>0.05)。MPR重建图像参照组并发症为3.85%,轴位图像参照组为26.92%,2组比较差异有统计学意义(P<0.05)。MPR重建图像参照组满意度为96.15%,对照组为76.92%,2组比较差异有统计学意义(P<0.05)。结论与常规轴位图像定位,使用MPR重建图像进行引导可以显著减少术中调整进针方向的次数和穿刺时间,降低术后疼痛评分。MPR重建图像参照组取材的准确性和穿刺成功率也较高。此外,MPR重建图像参照组的并发症发生率较低,并且患者满意度更高。Objective To investigate the application value of 64-slice spiral CT for multiplanar reconstruction(MPR)in CT-guided percutaneous liver puncture for biopsy.Methods Fifty-two patients who underwent liver puncture from January 2020 to December 2022 were selected as the study subjects.They were randomly assigned into the MPR group(n=26)and axial image group(n=26)using the randomized numerical table method.Conventional axial images were used to localize liver lesions in the axial image group,and the volumetric data were reconstructed in axial,sagittal,and coronal directions for guiding the trajectory of the puncture approach and localization of liver lesions in the MPR group.The number of intraoperative adjustments for the direction of needle insertion,accuracy of material extraction,postoperative complications,puncture time,puncture success rate,and postoperative pain were compared between the two groups.Results Patients in the MPR group had significantly less number of intraoperative adjustments for needle direction,shorter puncture time and less postoperative pain than those of the axial image group(P<0.05).The accuracy of material extraction and the puncture success rate in the MPR group were significantly higher than those of the axial image group without significant differences(P>0.05).The incidence of complications in the MPR group was significantly lower than that of the axial image group(3.85%vs 26.92%,P<0.05).The satisfaction rate of MPR group was significantly higher than that of the axial image group(96.15%vs 76.92%,P<0.05).Conclusion Compared with conventional axial image localization,64-slice spiral CT for multiplanar reconstruction(MPR)in CT-guided percutaneous liver puncture for biopsy achieves the goal of less number of intraoperative adjustments for needle direction,shorter puncture time,less postoperative pain,higher accuracy of material extraction and higher success rate of puncture.It also achieves lower incidence of complications and higher satisfaction rate.

关 键 词：64排螺旋CT多平面重建 分规角度导航 CT引导 经皮肝穿刺活检 

分 类 号：R445.3[医药卫生—影像医学与核医学]