多层螺旋CT仿真肝癌模型在介入治疗中的价值

目的 探讨多层螺旋CT仿真肝癌模型在介入治疗中的价值.方法 对42例原发性肝癌病人介入治疗前行螺旋CT增强扫描,利用选择性容积重建后处理技术建立仿真肝癌模型,观察仿真肝癌模型对肿瘤供血动脉、动静脉瘘和门脉癌栓的显示,并以此进行插管治疗,记录插管时间.结果 42例病人多层螺旋CT仿真肝癌模型和DSA对肝癌供血动脉及其走行的显示有很好的一致性,其中肝动脉解剖变异5例,膈动脉参与血供3例,胃左动脉参与血供2例,肋间动脉参与血供2例,肾上腺下动脉参与供血2例;多层螺旋CT仿真肝癌模型和DSA对肝动静脉瘘、门静脉癌栓的显示无差别(P>0.05);TACE插管时间较常规缩短.结论 多层螺旋CT仿真肝癌模型可清晰显示肿瘤血管及其走行,用于指导肝癌TACE治疗,可明显缩短插管和手术时间,获得较完全的栓塞,具有较大的临床价值.

Value of multislice spiral CT simulation model of hepatic carcinoma in interventional therapy

Objective To explore the value of multislice spiral CT (MSCT) simulation model of hepatic carcinoma in interventional therapy.Methods Enhanced MSCT was performed in 42 cases of primary hepatic carcinoma before interventional procedure.The simulation model was established with postprocessing software to demonstrate the supply blood arteries of tumor, hepatic arteriovenous shunt, tumor thrombosis of portal vein.The schemes of interventional therapy were worked out ac-cording to the findings of MSCT simulation model of hepatic carcinoma and the time of transcatheter procedure recorded.Results With respect to display quality in the supply arteries of tumors and its trend of 42 patients, there was good or fair correlation between MSCT simulation model of hepatic car-cinoma and DSA.MSCT simulation model of hepatic carcinoma could clearly demonstrate the suppl-ying blood vessels of tumors including hepatic arterial anomalies(5 cases), diphragmic arteries (3 ca-ses), left gastric arteries (2 cases), intercostal arteries (2 cases) and inferior suprarenal arteries (2 cases).There was no significance in demonstrating hepatic arteioportal shunt and tumor thrombosis of portal vein between MSCT simulation model of hepatic carcinoma and DSA (P>0.05).The duration of transeatheter procedure was lower than that of the routine procedure.Conclusion MSCT simula-tion model of hepatic carcinoma has high clinical value and it can clearly display the supplying arteries of tumors and its trend, markedly reduce the duraiton of transcatherter and operative procedure and obtain complete embolization.