旋转DSA在肝肿瘤介入治疗中的价值

目的 探讨快速旋转数字减影血管造影(DSA)技术在肝肿瘤经动脉栓塞术中的应用价值。资料与方法 采用Toshiba-2000DSA系统。42例肝肿瘤患者(肝癌39例，肝血管瘤3例)，每一病例均在介入治疗术前、术后行肝固有动脉常规正位血管造影及旋转DSA检查，比较两种方法显示肝内病灶个数及肿瘤供血动脉的敏感性。结果 快速旋转DSA能够显著提高前后重叠的小病灶检出率，旋转DSA发现9例常规DSA漏诊的小病灶。旋转DSA清晰地显示复杂的肿瘤供血动脉及其走行，并计算出导管的插入角度。但同时由于检查时间的延长，使得曝光剂量及对比剂的用量增加。结论 旋转DSA能够多方位清晰地显示迂曲走行的动脉和重叠隐匿的较小的肿瘤病灶，对提高超选择性插管的成功率和降低肝脏肿瘤的漏诊率有着重要意义，是一种重要的补充检查手段。

Evaluation of Rotational DSA in Interventional Therapy of Hepatic Neoplasm

Objective To evaluate rotational DSA in the interventional management of liver neoplasm.Materials and Methods With Toshia-2000 DSA unit, both conventional and rotational angiography of the proper hepatic artery were performed in 42 patients with liver neoplasm before and after the interventional management. The detection of the lesion's number and the tumor-feeding artery was compared between conventional and rotational angiographic images.Results Rotational DSA well improved the detection of small lesions, which were overlapped on conventional images. Rotational DSA revealed 9 small lesions, which were missed by conventional angiogaphy. Rotational DSA clearly displayed the complex tumor-feeding arteries. Rotational DSA increased the exam time, and, thus, increased the exposure dose. Conclusion Rotational DSA can well display tortuous arteries from different angles and detect small overlapped lesions. As an important supplement means, rotational DSA is of great help for improving the successful rate of super-selective catheterization.