肝癌患者间接门脉DSA与多排螺旋CT门脉造影三维成像的对比分析
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摘要
目的:探讨间接门脉DSA与16排多层螺旋CT门脉造影(SCTP)的门脉成像差异。
方法:对30例肝占位病变伴肝硬化患者均经肠系膜上动脉或腹腔动脉行间接门脉DSA和SCTP三维成像,对比分析2种影像质量差异。
结果:不同程度肝硬化的SCTP三维成像质量及显示门脉4~5级及分支破坏要优于间接门脉DSA,但显示门脉分支推移改变2种方法无差异,而在显示动静脉瘘和门脉癌栓方面,间接门脉DSA由于其动态显像性要优于CT门脉造影。
结论:在常规间接门脉DSA显示门脉欠佳时可选择SCTP检查以指导临床工作。
objective: The features of indirect portography DSA and Light Speed 16 Multiple Slice spiral-CT portography (SCTP) in portography imaging were comparatively studied.
Methods: 30 patients with space occupying diseases of liver accompanied by cirrhosis were examined by indirect portography DSA and 3D-SCTP.
Results: 3D-SCTP could visualize the 4-5 grades branches of portal vein. The display rate of destruction and deviation of distal PV in 3D-SCTP was higher than in indirect portography DSA. There was no difference in showing deviated branches of portal vein. Indirect portography DSA can play more important role in arteriovenous fistula than CT portography.
Conclusion: It was suggested that 3D-SCTP was helpful when display of portal vein by conventional indirect portography DSA is not very clear.
方法:对30例肝占位病变伴肝硬化患者均经肠系膜上动脉或腹腔动脉行间接门脉DSA和SCTP三维成像,对比分析2种影像质量差异。
结果:不同程度肝硬化的SCTP三维成像质量及显示门脉4~5级及分支破坏要优于间接门脉DSA,但显示门脉分支推移改变2种方法无差异,而在显示动静脉瘘和门脉癌栓方面,间接门脉DSA由于其动态显像性要优于CT门脉造影。
结论:在常规间接门脉DSA显示门脉欠佳时可选择SCTP检查以指导临床工作。
objective: The features of indirect portography DSA and Light Speed 16 Multiple Slice spiral-CT portography (SCTP) in portography imaging were comparatively studied.
Methods: 30 patients with space occupying diseases of liver accompanied by cirrhosis were examined by indirect portography DSA and 3D-SCTP.
Results: 3D-SCTP could visualize the 4-5 grades branches of portal vein. The display rate of destruction and deviation of distal PV in 3D-SCTP was higher than in indirect portography DSA. There was no difference in showing deviated branches of portal vein. Indirect portography DSA can play more important role in arteriovenous fistula than CT portography.
Conclusion: It was suggested that 3D-SCTP was helpful when display of portal vein by conventional indirect portography DSA is not very clear.
引文
1. 姚德茂,潘承恩,马兆龙。门静脉系统解剖及其在肝肿瘤治疗中的意义[J]。中国临床解剖学杂志,1995 ,13 (2) : 155-157.
2. 裘法祖。外科学[M]。第 4 版。北京:人民卫生出版社,1998.535.
3. 曹永胜, 顾王晋, 周康荣. 螺旋 CT 血管造影及三维重建的临床应用. 中华放射学杂志, 1997, 32 (2) : 96.
4. TaKayasu K, Muramatsu Y, Furukawa H et al. Earlyhepatocellularcarcinoam: appearance at CT daringarterial portography and CT arteriography with pathologic correlation. Radiology, 1995, 194: 101.
5. 胡道予, 胡国栋, 朱康顺等. 螺旋 CT 动脉门脉造影三维成像在肝内占位性病变门脉改变的价值. 临床放射学杂志, 1998, 17 (3): 144.
6. 胡道予, 胡国栋, 徐曼云,肖明. 间接门脉 DSA 与螺旋 CT 动脉门脉造影三维成像的对比分析. 华中科技大学学报(医学版),2002,31(2): 209.
7. Raptopoulos V , Steer ML , Sheiman RG, et al . The use of helical CT and CT angiography to predict vascular involvement from panceatic cancer : correlation with findings at surgery. AJR , 1997 , 168 :971.
8. Kuszyk BS , Osterman FA J r , Venbrux AC , et al . Portal venous system thrombosis : helical CT angiography before transjugular intrahepatic portosystemic shunt creation. Radiology , 1998 , 206 :179
9. 吴东,周康荣,陈祖望,等.螺旋 CT 门静脉血管造影的临床应用.中华放射学杂志,2000 ,34 :482.
10. 刘峰,田建明,贾雨辰,等.肝癌并门脉主干瘤栓地介入治疗及其预后的影响因素[J].中华放射学杂志,1999,33(8):538-541.
1. 姚德茂,潘承恩,马兆龙.门静脉系统解剖及其在肝肿瘤治疗中的意义[J].中国临床解剖学杂志,1995 ,13 (2) : 155-157.
2. 裘法祖。外科学[M].第 4 版。北京:人民卫生出版社,1998.535.
3. 于频. 系统解剖学[M] . 第 4 版. 北京:人民卫生出版社,1997. 129.
4. Soyer P , Heath D , Bluemke DA , et al. Three-dimensional helical CT of intrahepatic venous structures: comparison of three rending techniques[J] . J Comput Assist Tomogr, 1996, 20 (1) :122-127.
5. Rubin GD , Dake MD , Semba CP. Current status of 3D spiral CT scanning for imaging the vasculature. The Radiological Clinics of North America , 1995 , 3(1) : 65.
6. Nghien HV , Jeffrey Jr RB. CTAngiography of the visceral vasculature. Seminars in Ultrasound , CT and MRI , 1998, 19 : 439.
7. Kuszyk BS , Fishman EK. Technical aspects of CT angiography. Seminars in Ultrasound , CT and MRI , 1998, 19 : 383.
8. 严福华,陈刚,周康荣.螺旋 CT 肝脏检查中延迟时间的选择——Smartprep 技术的应用和评估.临床放射学杂志,1998 ,17 :339.
9. 王华明,蔡祖龙,赵红,等.门脉峰值时间确定及其在螺旋 CT 门脉成像中的应用.中国医学影像学杂志,2000,8(6):405-407.
10. 杨诚,周翔平,宋彬,等.正常人肝脏门静脉系统螺旋 CT 血管成像扫描时相的优化.中华放射学杂志,1999,33 :252.
11. 吴东,周康荣,陈祖望.螺旋 CT 门静脉造影延迟时间的合理选择.临床放射学杂志,1999 ,18 :272
12. Freund M, Wester F ,Reibe F ,et al . Spiral CT angiography or prceperative planning in patient with epigastric tumors : comparison with arterogranphy[J].Joumal of computer assisted tomography, 1996 ,20(8) :786 - 791.
13. 吕明德,梁力建,黄洁夫,等.原发性肝癌的门静脉血流动态声学造影与彩色多普勒所见[J].中国超声医学杂志,1994 ,10 (6) :24- 27.
14. Raptopoulos V , Steer ML , Sheiman RG, et al . The use of helical CT and CT angiography to predict vascular involvement from panceatic cancer : correlation with findings at surgery. AJR , 1997 , 168 :971.
15. Kuszyk BS , Osterman FA J r , Venbrux AC , et al . Portal venous system thrombosis : helical CT angiography before transjugular intrahepatic portosystemic shunt creation. Radiology, 1998, 206 :179.
16. 吴东,周康荣,陈祖望,等.螺旋 CT 门静脉血管造影的临床应用,中华放射学杂志,2000 ,34 :482
17. 曾蒙苏,严福华,周康荣.螺旋 CT 增强扫描显示肝静脉和门静脉及其解剖学形态的临床分析.中华放射学杂志,2000 ,34 :345.
18. 刘崎,田建明,贾雨辰,等.肝癌并门脉癌栓的介入治疗及其预后的影响因素.中华放射学杂志,1999 ,33 :538.
19. Kanematsu M , Hoshi H , Imaeda T , et al . Three-dimensional CT demonstration of intrahepatic portosystemic venous shunt draining into the inferior vena cave. Br J Radiol , 1997 , 70 :418.
20. 许崇永,周翔平,邓开鸿,等.门静脉高压侧支循环的螺旋 CT 表现.临床放射学杂志,1999 ,18 :280.
21. 吴东,周康荣,陈祖望等.螺旋 CT 与 MR 门静脉成像的对照研究.中华放射学杂志[J],2002,36(12):1138-1142.
22. HU H , He HD , Foley WD , et al . Four multidetectorrow helical CT:image quality and volume coverage speed. Radiology , 2000 , 215 : 552～621.
1. 乐杰主编.妇产科学.第五版.人民卫生出版社:323.
2. Hutchins FL Jr. Abdominal Myomectomy as a treatment for symptomatic uterine fibroids[J].ObsteOynecolClinNoahAm,1995,22(4):781-789.
3. RavinaJI-I,HerbreteauD,Ciraru-VigneronN,Ctal.Arterial embolization to treat uterine myomata[J]Lancet,1995,346(8976):671-672.
4. FairerBrowm G, Beilby JO,Tarbit MH.The Vascular patterns in myomatous uteri[J].ObstetOynaeeol Br Commonwealth,1970,77(11):96%975.
5. 刘晋波,/王文新,高平,等.子宫动脉栓塞术治疗子宫肌瘤的技术应用[J].中国医学影像技术 2003,19(1):95-97.
6. Worthington-Kirsch RL,Popky GL Hutchins FL.Uterine arterial embolization for the management of leiomyoimas;quality-of—life as sessment and clinical response.Radiology,1998,208(3):625-629.
7. Pelage JP, Le Dref O,Soyer P,et al.Fibroid related menorrhagia;treatment with superselective embolization of the uterine arteries and midterm follow up.Radiology,2000,215(2):428-431.
8. Bradlev EA,ReidyJF,Forman RG et al.Transcatheter uterine artery embolization to treat large Uterine fibroid.Br[J].Obstet Gynaecd,1998,105(2):235-240.
9. Hurst BS,Stackhouse DJ,Matthews ML et a1.Uterine artery embolization for symptomatic Uterine myomas [J].VascInterVRadiol,2000,74(5):855.
10. Chiesa AG, Hart WR.Uterine artery embolization of leiomyomas with trisacryl gelatin microspheres(TGM) : pathologic features and comparison with polyvinyl alcohol emboli[J] . Int Gynecol Pathol,2004,23(4):386-392.
11. 王杰,张国英,施海彬,等.葡聚糖微球栓塞治疗子宫肌瘤疗效的初步观察[J].介入放射学杂志,2003,12(6):417-419.
12. 牛惠敏.白芨混合微粒栓塞子宫肌瘤的临床研究[J].中国中医基础医学杂志,2000,28(2):46.
13. 柯要军,谭伟,姜陵,等.真丝线段颗粒栓塞双侧子宫动脉治疗子宫肌瘤[J].放射学实践,2001,16(3):159-162.
14. 陈君辉,胡大武,段天红,等.子宫肌瘤介入治疗临床疗效观察[J].中华放射学杂志,2001,35(5):334.
15. 李彦豪,刘彪,曾庆乐,等.平阳霉素碘油乳剂子宫动脉栓塞治疗症状性子宫肌瘤[J].中华放射学杂志,2000,34(12):827-830.
16. 李高文,刘素云,郭成月,等.综合应用碘油、PVA、明胶海绵颗粒介入治疗子宫肌瘤的临床研究[J].实用放射杂志,2001,17(12):915-917.
17. 王义清,王执民,郭卫平,等.不同栓塞剂栓塞了宫肌瘤的对比研究[J].临床放射学杂志,2002,21(4):310-312.
18. Ravina JH, Ledreff O. Arterial embolization of uterine myoma: results apropos of 286 cases[J].Gynecol Obstet Biol Reprod,2000,29(3):372-275.
19. Messina ML, Bozzini N, Halbe HW, et al. Uterine artery embolization for the treatment of uterine leiomyomata. Int J Gynaecol Obstet, 2002,79(1):11-16.
20. Broder MS, Goodwin S, Chen G, et al. Comparison of long-term outcomes of myomectomy and uterine artery embolization. Obstet Gynecol, 2002,100(5Pt 1):864-868.
21. 谭伟,柯要军,姜陵,等.子宫动脉栓塞治疗了宫肌瘤的中远期随访研究[J].中华放射学杂志,2003,37(7):648-653.
22. McLucas B, Adler L, Perrella R. Uterine fibroid embolization:nonsurgical treatment for symptomatic fibroids[J]. Am Coll Surg,2001(1),192:95-105.
23. 雷蔚华,陈春林,刘萍,等.患者自控镇痛在动脉栓塞治疗子宫肌瘤围手术期中的应用[J].现代妇产科进展,2001,10(2):102-104.
24. 陈俊,吴大哲,刘裕恒.不同镇痛方法在子宫肌瘤介入治疗中的效果分析[J].放射学实践,2003,18(10):787-788.
25. Payne JF, Robboy SJ, Haney AF. Embolic micro spheres within ovarian arterial vasculature after uterine artery embolization. Obstet Gynecol,2002,100(5Pt 1):883-886.
26. Chrisman HB, Saker MB, Ryu RK, et al. The impact of uterine fibroid embolization on resumption of menses and ovarian function. J Vasc Interv Radiol, 2000,11(6):699-703.
27. Ahmad A, Qadan L,Hassan N, et al. Uterine artery embolization treatment of uterine fibroids: effect on ovarian function in younger women. J Vasc Interv Radion,2002,13(10)1017-1020.
28. Razavi MK, Wolanske KA Hwang GL, et al. Angiographic classification of ovarian artery-to-uterine artery anastomoses: initial observation in uterine fibroid embolization. Radiology, 2002,224(3):707-712.
29. Goldberg J, Pereira L, Berghella V. Pregnancy after uterine arteryembolization. Obstet Gynecol,2002,100(5Pt 1):869-872.
2. 裘法祖。外科学[M]。第 4 版。北京:人民卫生出版社,1998.535.
3. 曹永胜, 顾王晋, 周康荣. 螺旋 CT 血管造影及三维重建的临床应用. 中华放射学杂志, 1997, 32 (2) : 96.
4. TaKayasu K, Muramatsu Y, Furukawa H et al. Earlyhepatocellularcarcinoam: appearance at CT daringarterial portography and CT arteriography with pathologic correlation. Radiology, 1995, 194: 101.
5. 胡道予, 胡国栋, 朱康顺等. 螺旋 CT 动脉门脉造影三维成像在肝内占位性病变门脉改变的价值. 临床放射学杂志, 1998, 17 (3): 144.
6. 胡道予, 胡国栋, 徐曼云,肖明. 间接门脉 DSA 与螺旋 CT 动脉门脉造影三维成像的对比分析. 华中科技大学学报(医学版),2002,31(2): 209.
7. Raptopoulos V , Steer ML , Sheiman RG, et al . The use of helical CT and CT angiography to predict vascular involvement from panceatic cancer : correlation with findings at surgery. AJR , 1997 , 168 :971.
8. Kuszyk BS , Osterman FA J r , Venbrux AC , et al . Portal venous system thrombosis : helical CT angiography before transjugular intrahepatic portosystemic shunt creation. Radiology , 1998 , 206 :179
9. 吴东,周康荣,陈祖望,等.螺旋 CT 门静脉血管造影的临床应用.中华放射学杂志,2000 ,34 :482.
10. 刘峰,田建明,贾雨辰,等.肝癌并门脉主干瘤栓地介入治疗及其预后的影响因素[J].中华放射学杂志,1999,33(8):538-541.
1. 姚德茂,潘承恩,马兆龙.门静脉系统解剖及其在肝肿瘤治疗中的意义[J].中国临床解剖学杂志,1995 ,13 (2) : 155-157.
2. 裘法祖。外科学[M].第 4 版。北京:人民卫生出版社,1998.535.
3. 于频. 系统解剖学[M] . 第 4 版. 北京:人民卫生出版社,1997. 129.
4. Soyer P , Heath D , Bluemke DA , et al. Three-dimensional helical CT of intrahepatic venous structures: comparison of three rending techniques[J] . J Comput Assist Tomogr, 1996, 20 (1) :122-127.
5. Rubin GD , Dake MD , Semba CP. Current status of 3D spiral CT scanning for imaging the vasculature. The Radiological Clinics of North America , 1995 , 3(1) : 65.
6. Nghien HV , Jeffrey Jr RB. CTAngiography of the visceral vasculature. Seminars in Ultrasound , CT and MRI , 1998, 19 : 439.
7. Kuszyk BS , Fishman EK. Technical aspects of CT angiography. Seminars in Ultrasound , CT and MRI , 1998, 19 : 383.
8. 严福华,陈刚,周康荣.螺旋 CT 肝脏检查中延迟时间的选择——Smartprep 技术的应用和评估.临床放射学杂志,1998 ,17 :339.
9. 王华明,蔡祖龙,赵红,等.门脉峰值时间确定及其在螺旋 CT 门脉成像中的应用.中国医学影像学杂志,2000,8(6):405-407.
10. 杨诚,周翔平,宋彬,等.正常人肝脏门静脉系统螺旋 CT 血管成像扫描时相的优化.中华放射学杂志,1999,33 :252.
11. 吴东,周康荣,陈祖望.螺旋 CT 门静脉造影延迟时间的合理选择.临床放射学杂志,1999 ,18 :272
12. Freund M, Wester F ,Reibe F ,et al . Spiral CT angiography or prceperative planning in patient with epigastric tumors : comparison with arterogranphy[J].Joumal of computer assisted tomography, 1996 ,20(8) :786 - 791.
13. 吕明德,梁力建,黄洁夫,等.原发性肝癌的门静脉血流动态声学造影与彩色多普勒所见[J].中国超声医学杂志,1994 ,10 (6) :24- 27.
14. Raptopoulos V , Steer ML , Sheiman RG, et al . The use of helical CT and CT angiography to predict vascular involvement from panceatic cancer : correlation with findings at surgery. AJR , 1997 , 168 :971.
15. Kuszyk BS , Osterman FA J r , Venbrux AC , et al . Portal venous system thrombosis : helical CT angiography before transjugular intrahepatic portosystemic shunt creation. Radiology, 1998, 206 :179.
16. 吴东,周康荣,陈祖望,等.螺旋 CT 门静脉血管造影的临床应用,中华放射学杂志,2000 ,34 :482
17. 曾蒙苏,严福华,周康荣.螺旋 CT 增强扫描显示肝静脉和门静脉及其解剖学形态的临床分析.中华放射学杂志,2000 ,34 :345.
18. 刘崎,田建明,贾雨辰,等.肝癌并门脉癌栓的介入治疗及其预后的影响因素.中华放射学杂志,1999 ,33 :538.
19. Kanematsu M , Hoshi H , Imaeda T , et al . Three-dimensional CT demonstration of intrahepatic portosystemic venous shunt draining into the inferior vena cave. Br J Radiol , 1997 , 70 :418.
20. 许崇永,周翔平,邓开鸿,等.门静脉高压侧支循环的螺旋 CT 表现.临床放射学杂志,1999 ,18 :280.
21. 吴东,周康荣,陈祖望等.螺旋 CT 与 MR 门静脉成像的对照研究.中华放射学杂志[J],2002,36(12):1138-1142.
22. HU H , He HD , Foley WD , et al . Four multidetectorrow helical CT:image quality and volume coverage speed. Radiology , 2000 , 215 : 552～621.
1. 乐杰主编.妇产科学.第五版.人民卫生出版社:323.
2. Hutchins FL Jr. Abdominal Myomectomy as a treatment for symptomatic uterine fibroids[J].ObsteOynecolClinNoahAm,1995,22(4):781-789.
3. RavinaJI-I,HerbreteauD,Ciraru-VigneronN,Ctal.Arterial embolization to treat uterine myomata[J]Lancet,1995,346(8976):671-672.
4. FairerBrowm G, Beilby JO,Tarbit MH.The Vascular patterns in myomatous uteri[J].ObstetOynaeeol Br Commonwealth,1970,77(11):96%975.
5. 刘晋波,/王文新,高平,等.子宫动脉栓塞术治疗子宫肌瘤的技术应用[J].中国医学影像技术 2003,19(1):95-97.
6. Worthington-Kirsch RL,Popky GL Hutchins FL.Uterine arterial embolization for the management of leiomyoimas;quality-of—life as sessment and clinical response.Radiology,1998,208(3):625-629.
7. Pelage JP, Le Dref O,Soyer P,et al.Fibroid related menorrhagia;treatment with superselective embolization of the uterine arteries and midterm follow up.Radiology,2000,215(2):428-431.
8. Bradlev EA,ReidyJF,Forman RG et al.Transcatheter uterine artery embolization to treat large Uterine fibroid.Br[J].Obstet Gynaecd,1998,105(2):235-240.
9. Hurst BS,Stackhouse DJ,Matthews ML et a1.Uterine artery embolization for symptomatic Uterine myomas [J].VascInterVRadiol,2000,74(5):855.
10. Chiesa AG, Hart WR.Uterine artery embolization of leiomyomas with trisacryl gelatin microspheres(TGM) : pathologic features and comparison with polyvinyl alcohol emboli[J] . Int Gynecol Pathol,2004,23(4):386-392.
11. 王杰,张国英,施海彬,等.葡聚糖微球栓塞治疗子宫肌瘤疗效的初步观察[J].介入放射学杂志,2003,12(6):417-419.
12. 牛惠敏.白芨混合微粒栓塞子宫肌瘤的临床研究[J].中国中医基础医学杂志,2000,28(2):46.
13. 柯要军,谭伟,姜陵,等.真丝线段颗粒栓塞双侧子宫动脉治疗子宫肌瘤[J].放射学实践,2001,16(3):159-162.
14. 陈君辉,胡大武,段天红,等.子宫肌瘤介入治疗临床疗效观察[J].中华放射学杂志,2001,35(5):334.
15. 李彦豪,刘彪,曾庆乐,等.平阳霉素碘油乳剂子宫动脉栓塞治疗症状性子宫肌瘤[J].中华放射学杂志,2000,34(12):827-830.
16. 李高文,刘素云,郭成月,等.综合应用碘油、PVA、明胶海绵颗粒介入治疗子宫肌瘤的临床研究[J].实用放射杂志,2001,17(12):915-917.
17. 王义清,王执民,郭卫平,等.不同栓塞剂栓塞了宫肌瘤的对比研究[J].临床放射学杂志,2002,21(4):310-312.
18. Ravina JH, Ledreff O. Arterial embolization of uterine myoma: results apropos of 286 cases[J].Gynecol Obstet Biol Reprod,2000,29(3):372-275.
19. Messina ML, Bozzini N, Halbe HW, et al. Uterine artery embolization for the treatment of uterine leiomyomata. Int J Gynaecol Obstet, 2002,79(1):11-16.
20. Broder MS, Goodwin S, Chen G, et al. Comparison of long-term outcomes of myomectomy and uterine artery embolization. Obstet Gynecol, 2002,100(5Pt 1):864-868.
21. 谭伟,柯要军,姜陵,等.子宫动脉栓塞治疗了宫肌瘤的中远期随访研究[J].中华放射学杂志,2003,37(7):648-653.
22. McLucas B, Adler L, Perrella R. Uterine fibroid embolization:nonsurgical treatment for symptomatic fibroids[J]. Am Coll Surg,2001(1),192:95-105.
23. 雷蔚华,陈春林,刘萍,等.患者自控镇痛在动脉栓塞治疗子宫肌瘤围手术期中的应用[J].现代妇产科进展,2001,10(2):102-104.
24. 陈俊,吴大哲,刘裕恒.不同镇痛方法在子宫肌瘤介入治疗中的效果分析[J].放射学实践,2003,18(10):787-788.
25. Payne JF, Robboy SJ, Haney AF. Embolic micro spheres within ovarian arterial vasculature after uterine artery embolization. Obstet Gynecol,2002,100(5Pt 1):883-886.
26. Chrisman HB, Saker MB, Ryu RK, et al. The impact of uterine fibroid embolization on resumption of menses and ovarian function. J Vasc Interv Radiol, 2000,11(6):699-703.
27. Ahmad A, Qadan L,Hassan N, et al. Uterine artery embolization treatment of uterine fibroids: effect on ovarian function in younger women. J Vasc Interv Radion,2002,13(10)1017-1020.
28. Razavi MK, Wolanske KA Hwang GL, et al. Angiographic classification of ovarian artery-to-uterine artery anastomoses: initial observation in uterine fibroid embolization. Radiology, 2002,224(3):707-712.
29. Goldberg J, Pereira L, Berghella V. Pregnancy after uterine arteryembolization. Obstet Gynecol,2002,100(5Pt 1):869-872.
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