16层螺旋CT肝脏三期扫描肝动脉三维重建对肝癌介入治疗的临床意义

目的 探讨16层螺旋CT肝脏三期扫描肝动脉三维重建对肝癌介入治疗的指导意义.方法 临床纳入原发性肝癌患者105例,所有患者均接受肝脏CT平扫以及三期增强扫描,并进行肝动脉期与门静脉期血管的三维重建,方法包括最大密度投影(MIP)以及容积再现(VR),比较2种重建方法对肝动脉以及门静脉吸痰的显示情况.此外,与同期进行肝动脉DSA的58例患者进行对比分析.结果 肝动脉期多层螺旋CT血管成像(MSCTA)可以清楚地显示出腹腔干主要分支、肝动脉、解剖变异肝动脉以及肿瘤的供血动脉.MIP与VP对2级以下肝动脉分支以及肿瘤供血动脉显示差异无统计学意义(P>0.05);MIP与VP对3级以上肝动脉分支以及肿瘤供血动脉显示差异有统计学意义(P<0.05).进行DSA检查的患者中,显示4级以上肝动脉方面,DSA明显优于MIP(P<0.05);在3级以下肝动脉显示方面,MIP与DSA差异无统计学意义(P>0.05).门静脉期MSCTA能够清楚地显示出肝内静脉4级以上的分支,MIP与VR差异无统计学意义(P>0.05).结论 MSCTA能够准确地显示肝脏血管系统以及其与原发性肝癌之间的联系,能够为外科及介入手术治疗提供可靠的客观依据.

Clinical Significance of Three-dimension Reconstruction of Hepatic Artery in the Interventional Treatment of Liver Cancer Based on the 16-slichelical CT

Objective To study the significance of three-dimension reconstruction of hepatic artery in the interventional treatment of liver cancer based on the 16-slice triple-phase helical CT.Methods 105 patients with primary liver cancer were se-lected.All the patients received CT plain scan and triple-phase enhancement scanning as well as three-dimension vascular recon-struction at hepatic artery and portal venous phase.Through MIP and VR,the sputum suction of hepatic artery and portal vein based on the 2 methods was compared.58 cases treated with DSA were also analyzed.Results According to MSCTA of hepatic artery phase ,the main celiac trunk branches , hepatic artery , anatomic variation of hepatic artery and tumor supply artery were clearly displayed.Based on MIP and VP ,the image display of hepatic artery branch and tumor supply artery at 2 levels or above was not significantly different(P>0.05);Based on MIP and VP,the image display of hepatic artery branch and tumor supply ar-tery at 3 levels or above was not significantly different ( P<0.05);for the hepatic artery at 4 levels or above ,the image display based on DSA was better than that of MIP (P<0.05);for the hepatic artery at 3 levels or below,the image display based on MIP and DSA was not significantly different (P>0.05);according to MSCTA of portal venous phase ,the trunk of intra-hepatic vein at 4 levels or above based on MIP and VR was not significantly different (P>0.05)(P<0.05).Conclusion MSCTA can correct-ly display the hepatic vessel and its correlation with primary liver cancer ,and provide the reliable and objective basis on the surgi-cal and interventional therapy.