CAJ | 학술논문

目的探讨CT三维血管重建技术对结直肠癌患者术前进行肿瘤血管评估的临床价值,为腹腔镜结直肠癌手术提供参考.方法 2010年2月至2010年12月间,对l1例准备行腹腔镜结直肠癌根治术的患者术前进行256层螺旋CT扫描,通过三维血管重建技术观察其肠系膜血管解剖及变异情况,并将结果与腹腔镜术中所见进行对照.结果 256层螺旋CT三维血管重建均清晰地显示出肠系膜血管解剖及变异情况,并与腹腔镜手术中所见吻合.3例右半结肠切除术患者中,1例回结肠动脉走行于肠系膜上静脉的腹侧,2例回结肠动脉走行于肠系膜上静脉的背侧:2例右结肠动脉和回结肠动脉分别直接起源于肠系膜上动脉,另1例未见右结肠动脉而由结肠中动脉右支参与供血.1例横结肠切除患者的结肠中动脉发自肠系膜上动脉.3例乙状结肠切除患者中,2例乙状结肠动脉与左结肠动脉共干起源于肠系膜下动脉,另1例乙状结肠动脉直接起源于肠系膜下动脉.4例直肠癌患者均由肠系膜下动脉延续的直肠上动脉供血.结论 256层螺旋CT血管重建技术可以满足腹腔镜结直肠癌根治术前对肠系膜血管解剖及变异情况的观察,为手术提供重要参考.
목적 탐토CT삼유혈관중건기술대결직장암환자술전진행종류혈관평고적림상개치,위복강경결직장암수술제공삼고.방법 2010년2월지2010년12월간,대l1례준비행복강경결직장암근치술적환자술전진행256층라선CT소묘,통과삼유혈관중건기술관찰기장계막혈관해부급변이정황,병장결과여복강경술중소견진행대조.결과 256층라선CT삼유혈관중건균청석지현시출장계막혈관해부급변이정황,병여복강경수술중소견문합.3례우반결장절제술환자중,1례회결장동맥주행우장계막상정맥적복측,2례회결장동맥주행우장계막상정맥적배측:2례우결장동맥화회결장동맥분별직접기원우장계막상동맥,령1례미견우결장동맥이유결장중동맥우지삼여공혈.1례횡결장절제환자적결장중동맥발자장계막상동맥.3례을상결장절제환자중,2례을상결장동맥여좌결장동맥공간기원우장계막하동맥,령1례을상결장동맥직접기원우장계막하동맥.4례직장암환자균유장계막하동맥연속적직장상동맥공혈.결론 256층라선CT혈관중건기술가이만족복강경결직장암근치술전대장계막혈관해부급변이정황적관찰,위수술제공중요삼고.
Objective To evaluate mesenteric vascular anatomy using 256 multi-slice computed tomography (MSCT) before laparoscopic colorectal surgery.Methods Eleven patients with colorectal cancer underwent 256 MSCT from February 2010 to December 2010.The evaluation items were visualization of mesenteric artery and vein by 3-dimensional CT angiography,which was compared with findings on laparoscopic surgery.Results Three-dimensional CT angiography correctly demonstrated variations of the mesenteric artery and vein and were consistent with laparoscopic findings.Of the 3 patients undergoing right hemicolectomy,ileocolic artery (ICA) ran ventrally to the superior mesenteric vein (SMV) in 1 patient,whereas ICA ran dorsally to the SMV in 2 patients; the right colic artery (RCA) branched directly from superior mesenteric artery(SMA) in 2 patients; RCA was absent and the left branch of middle colic artery (MCA) fed the tumor in 1 patient.In the patients who had transverse colon resection,MCA branched from SMA.In 2 of 3 patients who underwent sigmoidectomy,sigmoid artery (SA) branched from lefi colic artery(LCA); in 1 of 3 patients of sigmoid resection,SA branched from inferior mesenteric artery(IMA).In 4 patients with rectal cancer,the superior rectal artery (SRA) fed the tumor.Conclusion The 256 MSCT is effective for evaluating mesenteric vascular anatomy variation before laparoscopic surgery for colorectal cancer.