论文部分内容阅读
目的分析CTA在中晚期宫颈癌经动脉导管内化疗栓塞(TACE)治疗中的应用价值。方法回顾性分析连续采集的50例中晚期宫颈癌患者(年龄26～70岁,平均46岁)的数据;研究对象按纳入时间顺序分成三组,对应每组的患者分别为20、20、10例。第1组的患者直接行DSA寻找明确靶血管后行TACE治疗;第2组在CTA协助下,配合DSA确定靶血管后行TACE治疗;第3组尽可能不做DSA,依靠透视和CTA判断靶血管再行TACE治疗。所有患者均在TACE前进行了CTA检查,两名放射诊断医师独立分析CTA得出统一结果。衡量三组患者TA-CE治疗效率;研究对比参数包括:手术时间、透视时间、患者的辐射剂量、对比剂剂量等;对参数进行t检验。结果经CTA和DSA判断46例患者的靶动脉为双侧子宫动脉,并进行了常规经双侧子宫动脉TACE治疗(第1、2、3组研究对象对应的病例数分别是20、16和10例)。4例患者CTA图像双侧子宫动脉显示不清,术中DSA显示子宫动脉细小,导管进入困难,后行双侧髂内动脉灌注化疗。研究患者共100支子宫动脉中有92支(92%)在CTA中清晰显示。第2、3组对比第1组患者,在CTA帮助下并且少用DSA可使经双侧子宫动脉TACE手术时间缩短,从90.2min缩短到50.5 min(P=0.036),术中透视时间从28.3 min缩短到17.5 min(P=0.032),剂量面积乘积从109.5Gy.cm2降低到24.5 Gy.cm2(P<0.001),对比剂用量从100.4 ml降至25.0 ml(P<0.001)。结论 CTA在中晚期宫颈癌TACE术中运用有助于识别靶动脉,提高TACE治疗效率。
Objective To analyze the clinical value of CTA in the treatment of advanced cervical cancer with transcatheter arterial chemoembolization (TACE). Methods The data of 50 consecutive patients with advanced cervical cancer (aged from 26 to 70 years old, average 46 years old) collected from a consecutive period were retrospectively analyzed. The subjects were divided into three groups according to time sequence, corresponding to 20, 20, example. The patients in group 1 were directly treated with TACE for DSA. The patients in group 2 were treated with CTA and confirmed by DSA. TACE treatment was performed to determine the target vessels. Group 3 was asymptomatic with DSA and judged by fluoroscopy and CTA Vascular TACE treatment again. All patients underwent CTA examination before TACE, and two radiologists independently analyzed CTA to obtain uniform results. The TA-CE treatment efficiency was measured in three groups of patients. The parameters of the study included operation time, fluoroscopy time, radiation dose of the patient and contrast agent dose. The t-test was performed on the parameters. Results The CTA and DSA were used to determine the target artery in 46 patients as bilateral uterine arteries and routinely treated with bilateral uterine artery TACE (cases 1, 2 and 3 were 20, 16 and 10 respectively example). 4 cases of bilateral CTA images of uterine artery showed unclear, intraoperative DSA showed small uterine artery, catheter into difficulties, followed by bilateral internal iliac artery infusion chemotherapy. A total of 92 (92%) of 100 uterine arteries in the study patients were clearly shown in CTA. In group 2 and group 3, the duration of TACE with bilateral CTA was shortened from 90.2 min to 50.5 min (P = 0.036) with the help of CTA and less DSA with group C and group C, and the intraoperative fluoroscopy time ranged from 28.3 min to 17.5 min (P = 0.032). The dose area product decreased from 109.5 Gy.cm2 to 24.5 Gy.cm2 (P <0.001) and the contrast agent dosage decreased from 100.4 ml to 25.0 ml (P <0.001). Conclusion The use of CTA in TACE of advanced cervical cancer is helpful to identify the target artery and improve the efficiency of TACE treatment.