C臂CT成像在乏血供原发性肝癌诊疗中的临床应用

目的探讨C臂CT成像技术在乏血供原发性肝癌诊疗中的应用价值。方法回顾性分析43例乏血供原发性肝癌患者,使用数字减影血管造影(DSA)系统,在TACE前进行常规DSA造影和C臂CT成像,比较TACE治疗前CT/MRI、DSA造影和C臂CT成像对肝脏肿瘤的检出率。结果 TACE后CT扫描共发现97个乏血供肿瘤,CT/MRI、DSA造影、C臂CT成像3种检查方法的检出率分别为71.1%(69/97)、78.4%(76/97)、89.7%(87/97)(P<0.05)。其中,39个肿瘤直径<10 mm,3种检查方法的检出率分别为61.5%(24/39)、76.9%(30/39)、87.2%(34/39)(P<0.05);58个肿瘤直径≥10 mm,3种检查方法的检出率分别为77.6%(45/58)、79.3%(46/58)、87.9%(51/58)(P>0.05)。结论 C臂CT成像能更准确、更敏感地检测出乏血供肝脏肿瘤,尤其对于直径<10 mm的肿瘤,对原发性肝癌的治疗也有重要的临床价值。

The clinical application of C arm CT imaging in diagnosing and treating hypo-vascular primary hepatic carcinomas

Objective To investigate the clinical application of C arm CT imaging technique in diagnosing and treating of hypo-vascular primary hepatic carcinomas.Methods Forty-three patients with hypo-vascular primary hepatic carcinomas were enrolled in this study.All the patients underwent DSA and C arm CT imaging(Philips dual x-ray flat-panel digital imaging system) before transcatheter arterial chemoembolization(TACE).The imaging findings were retrospectively analyzed.The detection rate of hepatic tumors estimated before TACE were compared among CT/MRI,DSA and C arm CT imaging.Results After TACE a total of 97 hypo-vascular tumors were found on CT scanning.The detection rates of hepatic tumors on CT/MRI,DSA and C arm CT imaging were 71.1%(69/97),78.4%(76/97) and 89.7%(87/97),respectively,with P < 0.05.Thirty-nine lesions had a diameter < 10 mm,and the detection rates for them on CT/MRI,DSA and C arm CT imaging were 61.5%(24/39),76.9%(30/39) and 87.2%(34/39),respectively,with P < 0.05.Fifty-eight lesions had a diameter ≥10 mm,and the detection rates for them on CT/MRI,DSA and C arm CT imaging were 77.6%(45/58),79.3%(46/58) and 87.9%(51/58),respectively,with P > 0.05.Conclusion C arm CT imaging technique is superior to CT/MRI and DSA in detecting the hypo-vascular hepatic tumors.This technique can more precisely and more sensitively demonstrate the hepatic lesions,especially for the tumors with a diameter smaller than 10 mm.Therefore,this technique has great clinical value in treating hepatocellular carcinomas.