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目的研究Dyna CT(C-臂CT)在肝细胞肝癌(HCC)行肝动脉化疗栓塞(TACE)中的应用价值。方法 138例行TACE的HCC患者中,69例(A组)行Dyna CT和传统DSA,69例(B组)仅行DSA。观察腹腔干(CA)、肠系膜上动脉(SMA)及其分支的走形以及肿瘤供血动脉、肿瘤大小、数目,比较两组手术时间及患者2年总生存率。结果 A组中,Dyna CT显示60例肝动脉起源于CA,9例肝右动脉起源于SMA且肝左动脉起源于肝总动脉。Dyna CT共检测出258个肿瘤,多于传统DSA的178个(P<0.05)。A组手术时间短于B组[(43.6±15.8)min vs.(55.3±20.9)min],且2年总生存率高于B组(69.5%vs.53.6%)(P<0.05)。结论 Dyna CT在显示肿瘤数目、肝血管走行和分支方面优于传统DSA。Dyna CT可为TACE提供更优化的操作引导,使介入术中的精准超选更简单,提高TACE治疗质量。
Objective To study the application value of Dyna CT (C-arm CT) in hepatocellular carcinoma (HCC) for transcatheter arterial chemoembolization (TACE). Methods Among 138 HCC patients undergoing TACE, 69 cases (A group) were treated with Dyna CT and traditional DSA, and 69 cases (B group) were treated with DSA only. Observed the shape of celiac trunk (CA), superior mesenteric artery (SMA) and its branches, as well as the tumor feeding arteries, tumor size, and number, compared the operation time of the two groups and the 2-year overall survival rate of the patients. Results In group A, Dyna CT showed 60 cases of hepatic artery originated from CA, 9 cases of right hepatic artery originated from SMA and left hepatic artery originated from common hepatic artery. Dyna CT detected a total of 258 tumors, more than 178 of the traditional DSA (P<0.05). The operation time in group A was shorter than that in group B [(43.6±15.8) min vs. (55.3±20.9) min], and the 2-year overall survival was higher than that in group B (69.5% vs. 53.6%) (P<0.05). Conclusion Dyna CT is superior to traditional DSA in displaying the number of tumors, hepatic vessels walking and branches. Dyna CT provides TACE with more optimized operation guidance, making it easier to perform accurate overselection during interventions and improving the quality of TACE treatment.