多层螺旋CT血管成像技术对腹部肿瘤供血动脉来源的诊断价值分析

目的探讨多层螺旋CT血管成像技术（MSCTA）对腹部肿瘤供血动脉来源的诊断价值。 方法选取2014年2月至2017年2月恩施土家族苗族自治州中心医院经过腹部CT平扫或者超声检测显示腹部有肿瘤患者150例，使用16排多层螺旋CT进行容积扫描重新建立血管影像；成立两个诊断小组，分别为试验组和对照组，试验组诊断资料包含MSCTA资料和CT断面图像，对照组诊断资料只有CT断面图像，记录两组诊断的结果并和患者术后病理结果进行对比，统计两组诊断的准确性。 结果以VR或MIP重建的方法显示肿瘤的供血动脉113例（75.33%）。MIP图像血管显示清晰，对比度较高，特别是对腹主动脉的分支第3、4级小血管显示能力强，主动脉3级分支的显示率为61.33%（92/150），4级分支的显示率为10.00%（15/150）。VR图像立体感较强，重叠血管显示较合适，能够任意旋转，腹主动脉3级分支的显示率是60.67%（91/150），4级分支的显示率是6.00%（9/150）。试验组对患者手术前的定位诊断准确性为92.67%（139/150），定性诊断准确性为93.33%（140/150）；对照组对患者手术前的定位诊断准确性为72.00%（108/150），定性诊断准确性为90.00%（135/150），两组定位诊断准确性对比差异有统计学意义（χ²=22.023，P<0.01），定性诊断准确性对比差异无统计学意义（χ²=1.090，P=0.296）。 结论MSCTA可较好显现腹部肿瘤供血动脉，对腹腔来源不明肿瘤，MSCTA在术前诊断特别是定位诊断中临床价值较高。

Diagnostic value of multi-slice spiral CT angiography in the origin of abdominal tumor feeding artery

ObjectiveTo analyze the diagnostic value of multi-slice spiral CT angiography (MSCTA) in the origin of abdominal tumor feeding artery. MethodsFrom February 2014 to February 2017 in the Central Hospital of Enshi Autonomous Prefecture, one hundred and fifty patients were diagnosed of tumor after abdominal CT scan or abdominal ultrasonography, using 16 multi-slice spiral CT volume scanning to establish vascular image. Two diagnostic groups were established, with the experimental group diagnosis materials including MSCTA data and CT section the image, and the control group only CT diagnostic data section image. Results of two groups of diagnosis and postoperative pathological results were recorded and compared for the accuracy rate of diagnosis. ResultsThere were 113 cases (75.33%) of the blood supply arteries of the tumor displayed by the method of VR or MIP reconstruction. The MIP images showed clear blood vessels and high contrast, especially for the third, fourth small vessels of the abdominal aorta. The display rate of the 3 branch of the aorta was 61.33% (92/150), and 10% (15/150) for 4 grade branch. The VR image had a strong sense of stereo, and the overlapped blood vessels were more suitable and can rotate at any time. The display rate of the 3 branches of the abdominal aorta was 60.67% (91/150), and 6% (9/150) for the 4 grade branch.In the experimental group, the diagnosis accuracy rate before operation (tumor origin) was 92.67% (139/150), for the qualitative diagnosis (benign or malignant) was 93.33% (140/150); in the control group, the diagnosis accuracy rate was 72.00% (108/150), the qualitative accuracy rate was 90.00% (135/150), the difference of accurate diagnosis rate was statistically significant (χ²=22.023, P<0.01), the qualitative diagnostic accuracy showed no significant difference (χ²=1.090, P=0.296). ConclusionMSCTA can show the supply artery of abdominal tumor well, and it is of high clinical value in the preoperative diagnosis, especially for the localization diagnosis of MSCTA.