【摘要】：[目的]探討C臂CT在肝細(xì)胞癌TACE治療中的應(yīng)用價(jià)值。 [方法]80例肝細(xì)胞癌患者于2012年9月至2013年3月在我院接受TACE治療時(shí)行C臂CT掃描。評(píng)閱C臂CT平掃、動(dòng)脈早期、動(dòng)脈實(shí)質(zhì)期圖像及其后處理圖像,觀察TACE治療前病灶數(shù)量、供血?jiǎng)用}情況以及治療后病灶存活腫瘤、碘油沉積、供血?jiǎng)用}栓塞等情況,記錄患者檢查、治療全程皮膚所受X線輻射劑量,并與未行C臂CT掃描治療組的輻射劑量比較。 [結(jié)果]80例患者C臂CT掃描檢出病灶139個(gè),其中4例患者較64排螺旋CT掃描共多檢出5個(gè)病灶,2例患者較常規(guī)DSA檢查共多檢出2個(gè)病灶。TACE治療前,77例患者C臂CT掃描顯示131個(gè)病灶供血?jiǎng)用}清晰滿意,其中28例(36.36%)為使用微導(dǎo)管超選擇插管治療提供了直接的幫助；發(fā)現(xiàn)4例患者病灶異常供血?jiǎng)用},1例患者病灶供血?jiǎng)用}異常走行顯示清楚。TACE治療后,75例患者的128個(gè)病灶(128/139,92.09%)C臂CT掃描即時(shí)評(píng)價(jià)療效結(jié)果滿意,其中存活腫瘤較少78個(gè),存活腫瘤中等29個(gè),存活腫瘤較多21個(gè)；碘油沉積致密64個(gè),碘油沉積中等39個(gè),碘油沉積稀疏25個(gè)；栓塞治療后腫瘤血供明顯減少101個(gè),血供無(wú)明顯減少27個(gè)。接受C臂CT掃描的研究組患者皮膚所受X線輻射劑量平均為393.18mGy,未接受C臂CT掃描的對(duì)照組患者所受輻射劑量平均為401.05mGy,兩組輻射劑量平均值進(jìn)行獨(dú)立樣本t檢驗(yàn),差異無(wú)統(tǒng)計(jì)學(xué)意義(t值=0.355,P=0.723)。 [結(jié)論]C臂CT掃描在肝細(xì)胞癌TACE過(guò)程中,有助于病灶的檢出、供血?jiǎng)用}、異常供血?jiǎng)用}和動(dòng)脈異常走行的顯示,治療后存活腫瘤、碘油沉積、腫瘤供血?jiǎng)用}栓塞情況的即時(shí)評(píng)價(jià)等,不增加患者所受X線輻射劑量,應(yīng)用安全,前景廣闊。
[Abstract]:Objective to evaluate the value of C-arm CT in the treatment of hepatocellular carcinoma (HCC) with TACE. [methods] from September 2012 to March 2013, 80 patients with hepatocellular carcinoma underwent C-arm CT scan when they were treated with TACE in our hospital. To evaluate the plain scan of C-arm CT, the images of early arterial solid phase, arterial solid phase and post-processing images, and to observe the number of lesions before TACE treatment, the condition of blood supply artery, the survival tumor, the deposition of iodized oil and the embolism of blood supply artery after treatment. The X-ray radiation dose of the whole skin was recorded and compared with that of the non-C-arm CT scanning group. [results] 139 lesions were detected by C-arm CT in 80 patients, 5 more lesions were detected in 4 patients than 64-slice spiral CT scan, and 2 lesions were detected in 2 patients compared with conventional DSA. C-arm CT scan showed clear and satisfactory blood supply arteries in 77 patients, of which 28 (36.36%) provided direct help for the treatment of superselective catheterization with microcatheters. It was found that the abnormal blood supply artery was found in 4 patients, and the abnormal course of blood supply artery in 1 patient was clearly displayed. After treatment, 128 lesions (128 鈮，

本文編號(hào)：2476782