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C臂CT与血管造影技术在诊断肝癌血供来源及介入治疗中的价值对比
作者:李博1  张毅博2  艾宁1  王宁1  谷铁树1 
单位:1. 河北医科大学第四医院 放射科, 河北 石家庄 050011;
2. 河北省承德市围场县医院 肾内科, 河北 承德 068450
关键词:肝癌 C臂CT 血管造影 介入治疗 
分类号:R735.7;R445.3
出版年·卷·期(页码):2018·37·第一期(41-44)
摘要:

目的:针对C臂CT与血管造影技术在诊断肝癌血供来源及介入治疗中的价值进行分析讨论。方法:本研究选取本院就诊的确诊肝癌患者136例,均接受介入治疗;其中66例患者为C臂CT辅助介入诊断治疗组患者,即CT组;70例患者为DSA辅助介入诊疗组患者,即DSA组。比较两组方法对于诊断肿瘤血供情况以及辅助介入治疗的效果情况。研究中采用SPSS 17.0统计软件建立数据库并完成数据分析。结果:研究中,CT组患者CT影像与DSA影像结果比较提示患者主要病灶位置一致、数目以及大小基本吻合。CT组患者检61例(92.42%)患者为动脉多血供表现,5例(7.58%)患者为中等血供表现;DSA组提示60例(85.71%)为动脉多血供表现,有8例(11.43%)和2例(2.86%)为中等及少血供表现;两组间未见统计学差别。同时两种方法均为检出门脉直接血供表现病例;CT组提示可见7例(10.61%)门脉侧枝血供表现病例,DSA组提示6例(8.57%),未见组间差别。CT组治疗显效率为34.85%,显著高于DSA组(17.14%),P<0.05;此外,CT组的有效率为59.09%,总有效率以(显效+有效)/总例数×100%计算,研究中总有效率为93.94%;DSA组的有效率为71.43%,总有效率为88.57%,但有效率和总有效率两组间差别均未见统计学意义。结论:C臂CT辅助肝癌诊断治疗能够提供更详尽的实时细节影像信息,对于提高显效率有一定贡献,值得临床推广。

Objective: To analyze the value of C-arm CT and angiography in the diagnosis of liver cancer and the value of interventional therapy. Methods: Sixty-three patients with hepatocellular carcinoma confirmed by our hospital were treated with interventional therapy. Among them, 66 patients were C-arm CT-assisted interventional therapy group, CT group, 70 patients in DSA-assisted intervention group and DSA group. The Methods for the diagnosis of tumor blood supply and the effect of adjuvant intervention were compared. SPSS 17.0 statistical software was used to build the database and complete the data analysis. Results: In the study, CT images of the patients with both CT and DSA imaging results suggest that the location of the main lesion consistent with that of DSA, the number and size were basically matching. In the CT group, 61 patients(92.42%) had arterial blood supply, 5(7.58%) and moderate blood supply. The DSA group indicated that 60 cases(85.71%) showed arterial blood supply, 8 cases(11.43%) and 2 cases(2.86%) were moderate and less blood supply. There was no statistical difference between the two groups. At the same time, the two Methods were found to have direct blood supply of portal vein cases; CT group showed 7 cases(10.61%) cases of portal vein blood supply cases, DSA group suggested 6 cases(8.57%) portal vein blood supply cases with no differences between the two groups. The effective rate of CT group was significantly higher than that of DSA group(17.14%), P<0.05; In addition, the effective rate of CT group was 59.09%, the total effective rate was 93.94% in the study which was(effective + effective)/total number of cases×100%; DSA group effective rate was 71.43% The total effective rate was 88.57%, but the difference between the effective and the total effective rate was not statistically significant between the two groups. Conclusion: C-arm CT-assisted diagnosis and treatment of liver cancer can provide more detailed real-time image information, which has ertain contribution in improving the effective rate, thus it is worthy of clinical promotion.

参考文献:

[1] 丛文铭,步宏,陈杰,等.原发性肝癌规范化病理诊断指南(2015版)[J].临床与实验病理学杂志,2015,31(3):241-246.
[2] MINAMI Y,MURAKAMI T,KITANO M,et al.Cone-beam CT angiography for hepatocellular carcinoma:Current status[J].Dig Dis,2015,33(6):759-764.
[3] 祝普利,尹超,冯建龙.原发性肝癌综合治疗进展[J].临床肝胆病杂志,2015,31(6):965-968.
[4] TOGNOLINI A,LOUIE J D,HWANG G L,et al.Utility of C-arm CT in patients with hepatocellular carcinoma undergoing transhepatic arterial chemoembolization[J].J Vasc Interv Radiol,2010,21(3):339-347.
[5] 龚杰,宋云,徐尔侃,等.肝癌的临床治疗新进展[J].肝胆胰外科杂志,2016,28(6):522-525.
[6] 敖劲,曾令雯,刘衡,等.原发性肝癌DSA表现与TACE疗效的关系分析[J].中国普通外科杂志,2016,25(1):51-56.
[7] 孙厚坦,赵威武,陈朝旻,等.门静脉超声造影对肝细胞癌血供的观察[J].中华超声影像学杂志,2015(6):547-548.
[8] GROZINGER G,KUPFERSCHLAGER J,DITTMANN H,et al.Assessment of the parenchymal blood volume by C-arm computed tomography for radioembolization dosimetry[J].Eur J Radiol.2016,85(9):1525-1531.
[9] 包中涛,李海英,叶真,等.超声造影对肝脏局灶性病变误诊分析[J].中国介入影像与治疗学,2015,12(7):428-431.
[10] 冯少阳,石彦斌.超声造影与增强CT对肝脏局灶性病变诊断的对比研究[J].海南医学,2015,26(9):1292-1294.
[11] TACHER V,RADAELLI A,LIN M,et al.How I do it:Cone-beam CT during transarterial chemoembolization for liver cancer[J].Radiology.2015,274(2):320-334.
[12] PEYNIRCIOGLU B,HIZAL M,ÇIL B,et al.Quantitative liver tumor blood volume measurements by a C-arm CT post-processing software before and after hepatic arterial embolization therapy:comparison with MDCT perfusion[J].Diagn Interv Radiol.2015,21(1):71-77.
[13] 余炎,吕君,余祖江,等.四种影像学检查评价原发性肝癌患者介入治疗的疗效[J].实用肝脏病杂志,2017,20(2):199-202.
[14] 贵传玲.超声造影技术对原发性肝癌介入治疗效果的评估价值[J].山东医药,2016,56(33):86-88.
[15] 李海峰,耿丽莉,穆永胜,等.C臂CT技术在介入治疗肝细胞癌中的应用价值[J].中国临床研究,2015,28(6):795-797.

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