摘要
目的探讨肝癌TACE术中增加DSA斜位投照的意义。方法回顾性分析接受TACE术的肝癌患者127例，分别记录正位和右前斜30°～40°投照DSA图像中肝动脉分支重叠的轻、重程度以及两种投照位成功显示肿瘤供血动脉起源位置例数，评价两种方法的差异。结果正位投照时，肝动脉分支轻度重叠52例（52／127，40．94％），重度重叠75例（75／127，59．06％）；右前斜位投照时，肝动脉分支轻度重叠108例（108／127，85．04％），重度重叠19例（19／127，14．96o／t）。在对肿瘤供血动脉分支起源位置的观察中，单一正位可显示24例（24／127，18．90％），单一右前斜位可显示74例（74／127，58．27％），包括18例（18／127，14．17％）在正位和斜位均能分辨肿瘤供血动脉起源者。127例中，6例（6／127，4．72％）仅能在正位、56例（56／127，44．09％）仅能在右前斜位分辨肿瘤供血动脉起源位置，47例（47／127，37．01％）在两种位置均无法显示其起源。两种投照方法比较，显示上述肝动脉信息能力的差异有统计学意义（P均d0．05）。结论肝癌TACE术中增加右前斜30°～40°的投照体位，有助于减少正位投照时肝叶、肝段动脉分支影像重叠现象，更好显示肿瘤供血动脉起源；作为重要的补充投照体位，其有利于完成肝癌超选择插管TACE治疗。
Objective To investigate the significance of the oblique projection DSA for TACE in hepatocellular carcino- ma. Methods DSA data of TACE in 127 patients with hepatocellular carcinoma were retrospectively analyzed. All the pa- tients underwent postero-anterior and right anterior oblique 30°--40°projection DSA in sequence. The overlap lever of he- patic artery branches and the indications of tumor supply artery beginning were observed and quantified. The data were compared and analyzed statistically. Results Hepatic artery branches were less and more intermixed in 52 （52/127, 40.94%） and 75 patients （75/127, 59.06%） on postero-anterior projections and in 108 （108/127, 85.04%） and 19 pa- tients （19/127, 14.96%） on oblique projections. Tumor feeding arteries original sites could be recognized in 224 postero-an- terior projections （24/127, 18.90%） and in 74 oblique projections （74/1~7, 58.27%）, including 18 patients （18/127, 14.17%） with the original sites being well presented in both projections. The tumor supply artery original sites could only be displayed respectively in postero-anterior and adapted oblique 30°- 40° projection in 6 （6/127, 4.72%）and 56 patients （56/127, 44.09%）. And the tumor feeding arteries were unable to be found in both projections in 47 patients （47/127, 37.01%）. Abilities to display above hepatic artery information between the two project methods had significant differences （both P〈0.05）. Conclusion Right anterior oblique 30o--40° DSA projection is helpful to reduce the hepatic artery overlap and to increase the presentation rate of the tumor supply arteries original sites. As an important additional DSA projection, it is in favor of superselective TACE procedure, especially in those cases the hepatic artery branches intermixed obviously.
出处
《中国介入影像与治疗学》
CSCD
2014年第8期485-488,共4页
Chinese Journal of Interventional Imaging and Therapy
关键词
癌
肝细胞
斜位投照
血管造影术
数字减影
Carcinoma, hepatocellular
Oblique projection
Angiography, digital subtraction
