MSCTA在肝癌介入治疗术前的应用价值

目的 评价多层螺旋CT血管成像(multislice spiral CT angiography，MSCTA)在肝癌介入治疗术前的应用价值。方法 对62例肝癌患者肝动脉化疗栓塞前分别行MSCTA和数字减影血管造影(digital subtraction angiography，DSA)，分析肝动脉解剖、肝癌供养动脉及门静脉系统的显示情况。结果 MSCTA在显示腹腔动脉及肝动脉解剖方面与DSA高度一致。最大密度投影(maximum intensity projection，MIP)与DSA对肿瘤供养动脉的显示均优于容积重建(volume rendering，VR)(P＜0.05)；MIP对3级肝动脉显示优于VR(P＜0.05)，与DSA比较无差异；4级及以上肝动脉分支的显示MIP优于VR，DSA优于MIP，差异有统计学意义(P＜0.05)。MSCTA与DSA对门脉癌栓及侧支血管的显示无统计学差异(P＞0.05)，对肝动脉-门静脉瘘的显示DSA优于MSCTA(P＜0.05)。结论 MSCTA能准确显示肝癌供血动脉及门静脉系统，有效指导介入治疗。

Clinical value of MSCTA in interventional treatment of hepatocellular carcinoma

Objective To evaluate the clinical value of multislice spiral CT angiography(MSCTA) in the interventional treatment of hepatocellular carcinoma.Methods MSCTA and digital subtraction angiography(DSA) were performed in 62 hepatocellular carcinoma patients before the transcatheter hepatic artery chemoembolization.The images of hepatic artery anatomy,hepatic tumorous vascular system and portal vein system were analyzed.Results MSCTA was highly consistent with DSA in displaying the celiac artery and hepatic artery anatomy.Both the maximum intensity projection(MIP)and DSA were superior to volume rendering(VR) in demonstrating the tumor supplying arteries(P<0.05).MIP was better than VR(P<0.05) in demonstrating hepatic artery branches of grade 3,and there was no significant difference between DSA and MIP.For displaying the grade 4 or above hepatic arterial branches,DSA was better than MIP,and MIP was better than VR,and the difference was statistically significant(P<0.05).There was no significant difference between MSCTA and DSA in showing tumor thrombus of portal veins and portal venous collateral vessels(P>0.05).However,DSA was superior to MSCTA in demonstrating the hepatic artery-portal vein shunt(P<0.05).Conclusion MSCTA can accurately display supplying arteries of liver cancer and the portal vein system,and provide effective guidance for the interventional treatment.