锥形束CT用于肝转移瘤患者TACE术的价值观察

肝脏 ›› 2020, Vol. 25 ›› Issue (9): 926-929.

锥形束CT用于肝转移瘤患者TACE术的价值观察

姚欢, 梁春蕊, 何响玲, 张景, 林虹里, 钟红义, 王帆, 杨林

100122 北京市朝阳区桓兴肿瘤医院影像科(姚欢,林虹里,钟红义,王帆,杨林),放疗科(何响玲),腹部外科(张景);北京积水潭医院影像科(梁春蕊)

收稿日期:2020-04-08 出版日期:2020-09-30 发布日期:2020-10-22
基金资助:
北京市科技计划课题(Z131107002213029)

The value of cone beam computed tomography in the transcatheter arterial chemoembolization therapy for primary and metastatic liver cancers

YAO Huan¹, LIANG Chun-rui², HE Xiang-ling³, ZHANG Jing⁴, LIN Hong-li¹, ZHONG Hong-yi¹, WANG Fan¹, YANG Lin¹

1. Imaging department, Huanxing Tumor Hospital, Chaoyang District, Beijing, 100122;
2. Beijing Jishuitan Hospital 100035;
3. Chemoradiology Department, Huanxing Tumor Hospital, Chaoyang District, Beijing, 100122;
4. Abdominal surgery, Huanxing Tumor Hospital, Chaoyang District, Beijing, 100122

Received:2020-04-08 Online:2020-09-30 Published:2020-10-22

摘要/Abstract

摘要： 目的探讨锥形束CT(DynaCT)用于肝癌患者经导管肝动脉化疗栓塞(TACE)术的价值。方法 2016年11月—2019年11月我院收治的原发性或转移性肝癌患者153例,均行TACE手术治疗。所有患者术前均行普通螺旋CT检测,术中行DynaCT及数字减影血管造影(DSA)检测。比较普通螺旋CT、DSA、DynaCT检查对病灶的检出率,并比较DSA、DynaCT检查对病灶供血动脉的检出率,分析DSA、DynaCT检查评估TACE栓塞效果与实际栓塞效果的一致性。结果普通螺旋CT术前检出肿瘤病灶158个,DSA术中检出病灶264个,DynaCT术中检出病灶427个。普通螺旋CT平均检出病灶数目显著低于DSA、DynaCT(P<0.001),DSA平均检出病灶数目显著低于DynaCT(P<0.001)。DSA病灶供血动脉检出率为56.44%,显著低于DynaCT的87.12%(P<0.001)。DynaCT对检出的427个病灶行栓塞效果评估,与实际栓塞效果一致的有408个(95.55%)病灶;DSA对检出的264个病灶行栓塞效果评估,与实际栓塞效果一致的有205个(77.65%)病灶。DSA检查评估TACE栓塞效果与实际栓塞效果的一致性显著低于DynaCT(P<0.001)。结论 DynaCT在肝癌TACE手术治疗中具有重要的临床应用价值。

关键词: 锥形束CT, 肝癌, 经导管肝动脉化疗栓塞术

Abstract: Objective To explore the value of cone beam computed tomography (DynaCT) in transcatheter arterial chemoembolization (TACE) therapy for patients with primary or metastatic liver cancers. Methods One hundred and fifty-three patients with primary or metastatic liver cancers that received TACE surgery were studied. All patients were examined by spiral CT before operation, and DynaCT and digital subtraction angiography (DSA) during operation. The detection rates of common spiral computed tomography (CT), DSA and DynaCT for the focus of cancers, and the detection rates of DSA and DynaCT on the blood supply arterys of the focus of cancers was compared. The consistency between DSA and DynaCT in evaluating TACE embolization efficacy and actual embolization efficacy was analyzed. Results One hundred and fifty-eight tumor lesions were detected before operation, while 264 lesions were detected during DSA, and 427 lesions were detected during DynaCT. The average number of lesions detected by general spiral CT was significantly lower than that by DSA and DynaCT (P<0.001), and the average number of lesions detected by DSA was significantly lower than that by DynaCT (P<0.001). The detection rate of DSA for the arteries supplying the lesions was 56.44%, which was significantly lower than 87.12% of DynaCT (P<0.001). DynaCT performed embolization on 427 lesions, and 408 lesions (95.55%) were consistent with the actual embolization effect; DSA was used to evaluate the embolization effect of 264 lesions, and 205 lesions (77.65%) were consistent with the actual embolization effect. The consistency between the efficacy of TACE embolization evaluated by DSA and the efficacy of actual embolization was significantly lower than that of DynaCT (P<0.001). Conclusion DynaCT has important clinical application value in TACE therapy for liver cancers.

Key words: Cone beam computed tomography, Liver cancer, Transcatheter hepatic arterial chemoembolization

姚欢, 梁春蕊, 何响玲, 张景, 林虹里, 钟红义, 王帆, 杨林. 锥形束CT用于肝转移瘤患者TACE术的价值观察[J]. 肝脏, 2020, 25(9): 926-929.

YAO Huan, LIANG Chun-rui, HE Xiang-ling, ZHANG Jing, LIN Hong-li, ZHONG Hong-yi, WANG Fan, YANG Lin. The value of cone beam computed tomography in the transcatheter arterial chemoembolization therapy for primary and metastatic liver cancers[J]. Chinese Hepatolgy, 2020, 25(9): 926-929.

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