320排容积CT上腹部一站式检查在肝癌TACE治疗中的价值
发布时间：2018-10-10 07:48
【摘要】：目的探寻320排容积CT上腹部一站式检查在肝癌经动脉插管化疗栓塞（transcatheter arterial chemoembolization，TACE)治疗中的临床应用价值。 方法收集30例肝癌患者TACE术前行320排CT上腹部灌注扫描病例，分析全肝灌注情况，与TACE术中数字减影血管造影（digitalsubtraction angiography，DSA）图像对比了解其血管成像能力，术后随访病灶灌注情况并与术前对比分析。对320排灌注容积扫描行辐射剂量分析。 结果TACE术前肝癌组织肝动脉灌注量（hepatic arterialperfusion,HAP）、门静脉灌注量(portal vein perfusion,PVP)及肝动脉灌注指数（hepatic arterial perfusion index,HAPI)与非癌组织相比，差异有统计学意义（P0.05）；术后肿瘤坏死组织无血流灌注；肿瘤活性组织的HAP、PVP较术前升高，HAPI则下降，较术后非癌组织其HAP及HAPI升高，而PVP则明显降低，差异有统计学意义（P0.05）。30次扫描中均能获得满意上腹部CT血管成像（computer tomographyangiography,CTA)图像；对1～4级肝动脉CTA与DSA对比显示，差异无统计学意义（P0.05）,5级及以上肝动脉CTA与DSA比较，差异有统计学意义（P0.05）。剂量对比发现低参数（100kV、100mA）灌注扫描较常规上腹部增强扫描辐射剂量低，稍高参数灌注扫描方案（100kV、200mA）辐射剂量仅轻度增高。 结论320排容积CT上腹部一站式检查能很好的显示全肝灌注情况，，尤其是肝癌组织的异常灌注情况及术后活性灶，血管成像能够从三维角度显示肝动脉及肿瘤滋养动脉，对TACE术前评估、术中操作及术后随访都具有重要的指导意义。
[Abstract]:Objective to explore the clinical value of 320 row volume CT in the treatment of hepatocellular carcinoma (HCC) by arterial catheterization and chemoembolization (transcatheter arterial chemoembolization,TACE). Methods Thirty patients with hepatocellular carcinoma underwent 320 rows of CT upper abdominal perfusion scan before TACE. The total hepatic perfusion was analyzed and compared with TACE intraoperative digital subtraction angiography (digitalsubtraction angiography,DSA). Focus perfusion was followed up after operation and compared with that before operation. Radiation dose analysis was performed on 320 row perfusion volume scanning. Results the hepatic artery perfusion volume (hepatic arterialperfusion,HAP), portal vein perfusion volume (portal vein perfusion,PVP) and hepatic artery perfusion index (hepatic arterial perfusion index,HAPI) before TACE were significantly different from those in non-cancerous tissues (P0.05). The HAP,PVP of tumor active tissue was lower than that of preoperation, HAP and HAPI were higher than that of non-cancerous tissue after operation, but PVP was significantly lower. The difference was statistically significant (P0.05) .30 times of CT angiography (computer tomographyangiography,CTA) images of upper abdomen could be obtained. There was no significant difference in hepatic artery CTA and DSA between grade 1 and grade 4 (P0.05). CTA of grade 5 and above was significantly higher than that of DSA (P0.05). The dose contrast showed that the dose of low parameter perfusion scan (100kV / 100mA) was lower than that of conventional epigastric enhanced scan, and the radiation dose of a slightly higher perfusion scan scheme (100kV / 200mA) was only slightly higher than that of conventional epigastric enhanced scan. Conclusion One-stop CT can show the whole liver perfusion, especially the abnormal perfusion of liver cancer tissue and the postoperative active focus. Angiography can display the hepatic artery and tumor trophoblastic artery in three dimensional angle. It has important guiding significance for preoperative evaluation, intraoperative operation and postoperative follow-up of TACE.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R735.7;R730.55
本文编号：2261219
[Abstract]:Objective to explore the clinical value of 320 row volume CT in the treatment of hepatocellular carcinoma (HCC) by arterial catheterization and chemoembolization (transcatheter arterial chemoembolization,TACE). Methods Thirty patients with hepatocellular carcinoma underwent 320 rows of CT upper abdominal perfusion scan before TACE. The total hepatic perfusion was analyzed and compared with TACE intraoperative digital subtraction angiography (digitalsubtraction angiography,DSA). Focus perfusion was followed up after operation and compared with that before operation. Radiation dose analysis was performed on 320 row perfusion volume scanning. Results the hepatic artery perfusion volume (hepatic arterialperfusion,HAP), portal vein perfusion volume (portal vein perfusion,PVP) and hepatic artery perfusion index (hepatic arterial perfusion index,HAPI) before TACE were significantly different from those in non-cancerous tissues (P0.05). The HAP,PVP of tumor active tissue was lower than that of preoperation, HAP and HAPI were higher than that of non-cancerous tissue after operation, but PVP was significantly lower. The difference was statistically significant (P0.05) .30 times of CT angiography (computer tomographyangiography,CTA) images of upper abdomen could be obtained. There was no significant difference in hepatic artery CTA and DSA between grade 1 and grade 4 (P0.05). CTA of grade 5 and above was significantly higher than that of DSA (P0.05). The dose contrast showed that the dose of low parameter perfusion scan (100kV / 100mA) was lower than that of conventional epigastric enhanced scan, and the radiation dose of a slightly higher perfusion scan scheme (100kV / 200mA) was only slightly higher than that of conventional epigastric enhanced scan. Conclusion One-stop CT can show the whole liver perfusion, especially the abnormal perfusion of liver cancer tissue and the postoperative active focus. Angiography can display the hepatic artery and tumor trophoblastic artery in three dimensional angle. It has important guiding significance for preoperative evaluation, intraoperative operation and postoperative follow-up of TACE.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R735.7;R730.55
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