中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
3期
165-168
,共4页
王劲%谢斯栋%罗琳%张建生%刘凌云%徐川%姜在波%杨扬%张亚琴%邝思驰%胡冰%单鸿
王勁%謝斯棟%囉琳%張建生%劉凌雲%徐川%薑在波%楊颺%張亞琴%鄺思馳%鬍冰%單鴻
왕경%사사동%라림%장건생%류릉운%서천%강재파%양양%장아금%광사치%호빙%단홍
肝移植%体层摄影术%X线计算机%肝动脉
肝移植%體層攝影術%X線計算機%肝動脈
간이식%체층섭영술%X선계산궤%간동맥
Liver transplantation%Tomography%X-ray computed%Hepatic artery
目的 探讨320排CT的低对比剂4D DSA对肝移植后肝动脉并发症的临床应用价值.方法 回顾性分析2008年11月至2009年1月中山大学器官移植中心15例肝移植病例,患者均采用TOSHIBA 320排CT-Aquilion One扫描机,造影剂流速6 ml/s,总剂量50 ml,动态容积扫描模式,利用4D DSA成像软件,测量纯肝动脉的强化峰值时间、CT值.选取最佳纯肝动脉期的图像,进行容积(VR),最大密度投影(MIP),多层面重建(MPR)图像重建.结果 肝动脉的强化峰值时间为20(10.0～24.2)s,强化CT峰值为373(310～440)HU.肝动脉吻合口假性动脉瘤2例,肝动脉吻合口轻度、中度狭窄各为3例、4例,肝动脉吻合口闭塞、重度狭窄各1例,肝动脉吻合口未见异常4例.其中肝动脉闭塞、重度狭窄者伴有肝门部侧支动脉形成,伴有肝动脉分支局限性与节段性狭窄、肝动脉-门静脉瘘及肝动脉迂曲、肝内动脉小分支开放各4例,其他包括9例伴有肝内动脉小分支稀疏,3例供受体肝动脉管径粗细不一致,1例移植肝血管瘤,呈"挂果征",脾动脉瘤、脾动脉瘤样扩张各1例.结论 320排CT低对比剂的4D DSA成像可获得准确的纯动脉期肝动脉图像,对于肝移植术后肝动脉病变的诊断具有安全、无创、准确的优点,可作为肝移植术后对肝动脉并发症进行随访的有效手段.
目的 探討320排CT的低對比劑4D DSA對肝移植後肝動脈併髮癥的臨床應用價值.方法 迴顧性分析2008年11月至2009年1月中山大學器官移植中心15例肝移植病例,患者均採用TOSHIBA 320排CT-Aquilion One掃描機,造影劑流速6 ml/s,總劑量50 ml,動態容積掃描模式,利用4D DSA成像軟件,測量純肝動脈的彊化峰值時間、CT值.選取最佳純肝動脈期的圖像,進行容積(VR),最大密度投影(MIP),多層麵重建(MPR)圖像重建.結果 肝動脈的彊化峰值時間為20(10.0～24.2)s,彊化CT峰值為373(310～440)HU.肝動脈吻閤口假性動脈瘤2例,肝動脈吻閤口輕度、中度狹窄各為3例、4例,肝動脈吻閤口閉塞、重度狹窄各1例,肝動脈吻閤口未見異常4例.其中肝動脈閉塞、重度狹窄者伴有肝門部側支動脈形成,伴有肝動脈分支跼限性與節段性狹窄、肝動脈-門靜脈瘺及肝動脈迂麯、肝內動脈小分支開放各4例,其他包括9例伴有肝內動脈小分支稀疏,3例供受體肝動脈管徑粗細不一緻,1例移植肝血管瘤,呈"掛果徵",脾動脈瘤、脾動脈瘤樣擴張各1例.結論 320排CT低對比劑的4D DSA成像可穫得準確的純動脈期肝動脈圖像,對于肝移植術後肝動脈病變的診斷具有安全、無創、準確的優點,可作為肝移植術後對肝動脈併髮癥進行隨訪的有效手段.
목적 탐토320배CT적저대비제4D DSA대간이식후간동맥병발증적림상응용개치.방법 회고성분석2008년11월지2009년1월중산대학기관이식중심15례간이식병례,환자균채용TOSHIBA 320배CT-Aquilion One소묘궤,조영제류속6 ml/s,총제량50 ml,동태용적소묘모식,이용4D DSA성상연건,측량순간동맥적강화봉치시간、CT치.선취최가순간동맥기적도상,진행용적(VR),최대밀도투영(MIP),다층면중건(MPR)도상중건.결과 간동맥적강화봉치시간위20(10.0～24.2)s,강화CT봉치위373(310～440)HU.간동맥문합구가성동맥류2례,간동맥문합구경도、중도협착각위3례、4례,간동맥문합구폐새、중도협착각1례,간동맥문합구미견이상4례.기중간동맥폐새、중도협착자반유간문부측지동맥형성,반유간동맥분지국한성여절단성협착、간동맥-문정맥루급간동맥우곡、간내동맥소분지개방각4례,기타포괄9례반유간내동맥소분지희소,3례공수체간동맥관경조세불일치,1례이식간혈관류,정"괘과정",비동맥류、비동맥류양확장각1례.결론 320배CT저대비제적4D DSA성상가획득준학적순동맥기간동맥도상,대우간이식술후간동맥병변적진단구유안전、무창、준학적우점,가작위간이식술후대간동맥병발증진행수방적유효수단.
Objective To evaluate the value of low-dose contrast-enhanced 4D DSA acquired from 320-detector row CT on the diagnosis of the hepatic artery complications after liver transplantation. Methods 320-detector row CT were performed in fifth patients with liver dynamic enhanced using volume CT body-perfusion protocol, hepatic artery phase images obtained after intravenous injection of 50 ml of contrast at a rate of 6 ml/s were acquired based on 4D DSA. The time-density curve (TDC) of the hepatic artery was delineated. The time to peak, peak contrast enhancement were recorded. The data of artery phase were sent to workstation to reconstruct the hepatic artery with VR, MIP and MPR. Results The delay mean time and the peak CT value of hepatic artery was 20(10. 0-24. 2) s and 373(310-440) HU; 4D DSA revealed hepatic artery pseudo-aneurysm (n=2) , and hepatic artery mild stenosis(n =3) , moderate stenosis (n =4) , severe stenosis(n = 1) and occlusion (n = 1). Compensatory circulation was seen in 2 cases. 4 patients were appeared segmental stenosis and hepatoportal arteriovenous fistulas (HPAVF). Hepatic arterial branch are decreased and opened in 9 cases and 4cases. 4D DSA also displayed other signs including hepatic hemangioma and the splenic artery aneurysms (SAA) and ectasi (n = 1) , donor-recipient hepatic artery mismatch (n=3). Conclusion 4D DSA provided a safe, noninvasive and accurate method for guiding the diagnosis of hepatic artery complication and play an effective role after liver transplantation.
