移动式C臂DSA机与CT机的联合导向在介入手术中的应用

目的 探讨移动式C臂DSA机与CT联合导向下行介入治疗的定位、操作方法及意义。方法 将移动式C臂DSA机与CT机组成联合机。先用体表标记尺与CT扫描来确定穿刺点，测量出进针的角度及深度。在C臂机实时透视监视下将穿刺针穿刺达病变部位后，再作CT扫描证实。最后在C臂机实时透视下完成药物注射治疗。共治疗142例，主要包括：经皮肺穿刺活检术，经皮肝穿刺治疗肝肿瘤、腹膜后淋巴结转移，经皮肝脓肿穿刺留置导管引流术，经皮穿刺椎体成形术，经皮穿刺腰椎间盘手术，经皮穿刺椎体骨活检术等。结果 在组合机导向下行介入手术142例共158次操作，成功率100％，无严重并发症发生。结论 移动式C臂DSA机与CT机联合导向操作简便，具有定位准确，实时监视的优点，为介入治疗提供了更加安全的导向方法，扩大了介入放射学的应用范围。

Interventional radiology procedures under the guidance of a combination of CT and C-arm DSA

Objective To investigate the localization and manipulation in the interventional procedures under the guidance of a combination of CT and C-arm DSA. Methods The combination of machine was made of CT and C-arm DSA.The site of puncture was determined by mark-ruler and CT scan.Then the angle and depth of puncture was measured. Puncture was performed under the monitor of C-arm DSA fluoroscopy. The needle tip was put to the target point monitored by C-arm fluoroscopy, and then confirmed by CT after successful puncture.Medicines were injected under the monitor of real-time fluoroscopy. 142 patients treated underwent biopsy in lungs,percutaneous ethanol injection treatment of hepatic cancer, percutaneous vertebroplasty, percutaneous lumbar diskectomy, and so on. Results Total 158 procedures on 142 patients were successfully performed under the combined machine guidance.The rate of successful technique was 100%.No serious complication was found. Conclusions Combined machine, a safe guidance for interventional radiology,can be manipulated easily,which offers accurate location and real-time fluoroscopy.It expands the range of use of interventional radiology.