CAJ | 학술논문

目的探讨DSA与MSCTA在肺癌介入治疗中协同应用的价值.方法肺癌介入治疗患者46例,术前均行MSCT平扫加增强.其中,26例术前通过容积显示(VR)、最大密度投影(MIP)、多平面重建(MPR)等三维重组技术完成肺癌供血动脉MSCTA后行DSA造影及介入治疗,即为CTA组.20例未行MSCTA重组,即为无CTA组.对两组术中查找肿瘤供血动脉数量、选用导管数量、对比剂用量、减影采集序列次数、透视时间及手术时间等结果进行评价分析.结果全组46例均插管成功,并完成介入治疗.CTA组术中DSA造影显示供血动脉情况与MSCTA显示一致.两组术中在查找供血动脉数量差异无统计学意义(P>0.05),但在选用导管数量、对比剂用量、减影采集次数、透视时间及手术时间等差异有统计学意义(P<0.05),且CTA组均少于无CTA组.而对支气管动脉变异、多支动脉及肺外体循环动脉参与供血的显示,CTA组优于无CTA组.CTA组未出现严重并发症而无CTA组中1例术后出现"脊前动脉综合征".结论 DSA与MSCTA在肺癌介入治疗中的协同应用是较合理、可行的操作方案,术前常规行MSCTA有利于降低术中操作难度、减少并发症,有助于提高肺癌介入疗效.
목적 탐토DSA여MSCTA재폐암개입치료중협동응용적개치.방법 폐암개입치료환자46례,술전균행MSCT평소가증강.기중,26례술전통과용적현시(VR)、최대밀도투영(MIP)、다평면중건(MPR)등삼유중조기술완성폐암공혈동맥MSCTA후행DSA조영급개입치료,즉위CTA조.20례미행MSCTA중조,즉위무CTA조.대량조술중사조종류공혈동맥수량、선용도관수량、대비제용량、감영채집서렬차수、투시시간급수술시간등결과진행평개분석.결과 전조46례균삽관성공,병완성개입치료.CTA조술중DSA조영현시공혈동맥정황여MSCTA현시일치.량조술중재사조공혈동맥수량차이무통계학의의(P>0.05),단재선용도관수량、대비제용량、감영채집차수、투시시간급수술시간등차이유통계학의의(P<0.05),차CTA조균소우무CTA조.이대지기관동맥변이、다지동맥급폐외체순배동맥삼여공혈적현시,CTA조우우무CTA조.CTA조미출현엄중병발증이무CTA조중1례술후출현"척전동맥종합정".결론 DSA여MSCTA재폐암개입치료중적협동응용시교합리、가행적조작방안,술전상규행MSCTA유리우강저술중조작난도、감소병발증,유조우제고폐암개입료효.
Objective To evaluate the synergistic effect of DSA and MSCTA in interventional therapy for lung cancer. Methods Interventional therapy was performed in 46 patients with lung cancer. With real time helical thin slice CT scanning, MSCTA of tumor feeding artery was performed in 26 patients. Images obtained from enhanced MSCT scanning were processed at the console workstation. Spatial anatomical characteristics of tumor feeding artery were observed by using different rotations of view. DSA study and the interventional therapy were followed up in 26 patients with lung cancer. Results All tumor feeding arteries in 26 patients with lung cancer were observed by using VR, MIP and MPR, which could exactly display the origin, course and diameter of the vessels. DSA had a high consistency with MSCTA in displaying the tumor vascularity, tumor stain, and the origin of tumor-feeding artery in the patients who received MSCTA and the interventional therapy. The number of catheter used, the dosage of contrast medium, the sequence of subtraction, the fluoroscopic time and operation time in the group with use of CTA was less than that in the group without use of CTA, and the difference between two groups was statistically significant (P < 0.05), while no significant difference in detecting feeding artery existed between two groups (P > 0.05). Conclusion The anatomical characteristics of tumor-feeding artery in patients with lung cancer can be stereoscopically and clearly displayed on preoperative routine MSCTA, providing useful information and thus making the interventional procedure more safe and effective. Simultaneous use of DSA and MSCTA is reasonable and practicable, which has synergistic effect in interventional therapy for lung cancer.