CT血管造影在肝癌患者血供特点及血流灌注动态变化研究中的应用-现代医学

CT血管造影在肝癌患者血供特点及血流灌注动态变化研究中的应用

单位：江汉油田总医院放射科, 湖北潜江 433124

分类号：R735.7;R730.44

出版年·卷·期（页码）：2018·46·第十一期（1279-1282）

摘要：

目的：探讨CT血管造影（CTA）在中晚期肝癌患者血供特点及血流灌注动态变化研究中的应用价值。方法：回顾性分析2012年12月至2017年12月就诊于本院的64例中晚期肝癌患者数字减影血管造影（DSA）及CTA资料，观察直接参与肿瘤供血的变异动脉起源及分布情况。结果：与DSA对照，CTA准确显示肝动脉解剖变异61例，准确率为95.31%；余3例未能在CTA显示副肝左动脉及副肝右动脉变异。DSA稍优于CTA，但两者差异无统计学意义（P>0.05）。64例肝癌患者中18例肝癌合并动门脉分流。DSA对诊断周围型肝癌合并动门脉分流优于CTA，差异有统计学意义（P<0.05）。两者显示中央型和弥漫型肝癌合并动门脉分流的差异无统计学意义（P>0.05）。结论：DSA及CTA显示肝癌肿瘤供血变异动脉无差异，显示中央型和弥漫型肝癌合并动门脉分流也无差异，但DSA显示周围型肝癌合并动门脉分流优于CTA。

Objective:To investigate the value of digital subtraction angiography(DSA) and CT angiography (CTA) in the study of blood supply characteristics and blood perfusion dynamics in patients with advanced liver cancer. Methods:64 cases of middle and late stage liver cancer were retrospectively analyzed. Data of DSA and CTA in patients with liver cancer were retrospectively analyzed to demonstrate the origin and distribution of variant arteries directly involved in the blood supply of tumor, and the diagnostic value of DSA and CTAwas evaluated. Results:After DSA and CTA, 61 cases of CTA were accurately displayed, and the accuracy rate was 95.31%. The left accessory hepatic artery and right accessory hepatic artery were not found in the remaining 3 cases on CTA. DSA was slightly superior to CTA, but the difference was not statistically significant (P>0.05). Among them, 18 cases of HCC were complicated with arterioportal shunt APS. DSA was better than CT in the diagnosis of peripheral hepatocellular carcinoma with portal shunt (P<0.05). There was no significant difference in portal shunt between central type and diffuse type of liver cancer (P>0.05). Conclusion:There was no significant difference between DSA and CTA in the distribution of variant arteries in HCC tumor. There is no significant difference between central type and diffuse type APS. DSA was superior to CT in displaying peripheral APS.

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