CAJ | 학술논문

目的：探讨腹腔动脉及其分支多层螺旋CT血管成像在肝脏肿块介入治疗中的应用价值。方法应用Siemens Definition AS 128层螺旋CT机，对29例肝脏肿块患者进行上腹部MSCTA检查，并对腹腔动脉及其分支进行最大密度投影（MIP）、多平面重组（MPR）、曲面重组（CPR）、容积成像（VR）等三维重组。结果腹腔动脉及其分支显示率：脾动脉、肝总动脉、胃十二指肠动脉显示率为100%，胃左动脉、肝固有动脉、肝左动脉96.5%，肝右动脉93%，肿瘤供血动脉79%。腹腔动脉开口对应T12左上缘4例，T12左下缘11例，L1左上缘12例，L1左下缘2例。开口于腹主动脉左前壁21例，前壁7例，左壁1例。肝脾胃左动脉型25例，肝脾型3例，脾胃左型1例。腹腔动脉长度最长4.9 cm，最短1.9 cm。与腹主动脉间下夹角最大107°，最小14°。结论多层螺旋CT三维重组技术能直观、立体反映腹腔动脉开口部位、开口方向、长度、与腹主动脉间角度，走行及其分支、变异，肿瘤供血动脉等，对介入手术具有导航作用。
목적：탐토복강동맥급기분지다층라선CT혈관성상재간장종괴개입치료중적응용개치。방법응용Siemens Definition AS 128층라선CT궤，대29례간장종괴환자진행상복부MSCTA검사，병대복강동맥급기분지진행최대밀도투영（MIP）、다평면중조（MPR）、곡면중조（CPR）、용적성상（VR）등삼유중조。결과복강동맥급기분지현시솔：비동맥、간총동맥、위십이지장동맥현시솔위100%，위좌동맥、간고유동맥、간좌동맥96.5%，간우동맥93%，종류공혈동맥79%。복강동맥개구대응T12좌상연4례，T12좌하연11례，L1좌상연12례，L1좌하연2례。개구우복주동맥좌전벽21례，전벽7례，좌벽1례。간비위좌동맥형25례，간비형3례，비위좌형1례。복강동맥장도최장4.9 cm，최단1.9 cm。여복주동맥간하협각최대107°，최소14°。결론다층라선CT삼유중조기술능직관、입체반영복강동맥개구부위、개구방향、장도、여복주동맥간각도，주행급기분지、변이，종류공혈동맥등，대개입수술구유도항작용。
Objective To explore the value of multi-slice CT angiography(CTA)of the celiac artery in interventional treatment of hepatic tumor.Methods Abdominal 128-slice CTA was performed on 29 patients.The maximum intensity projection, multiplanar reconstruction,curved planar reconstruction,and volume rendering reconstructed images of the celiac artery and its branches were analyzed.Results All of the splenic,common hepatic and gastroduodenal arteries,96.5%of the left gastric,proper hepatic and left hepatic arteries,93%of the right hepatic arteries,and 79%of supplying arteries to the tumors were visible.The origins of celiac arteries were located at the left upper T12(4),lower left T12(11),upper left L1(12),and lower left L1(2)levels. The celiac arteries arose from the left anterior(21),anterior(7),left lateral(1)walls of the abdominal aorta.Common origin of hepatic,splenic and left gastric arteries was seen in 25 patients,common origin of hepatic and splenic arteries in 3 patients,common origin of splenic and left gastric arteries in 1 patient.The length of celiac arteries ranged from 1.9 cm to 4.9 cm and the angles between the celiac arteries and abdominal aorta ranged from 14°to 107°.Conclusions The origin,course,length,branches,and variation of the celiac artery,the supplying artery of hepatic tumor,and the angles between abdominal aorta and celiac artery can be depicted accurately by 3D reconstruction of 128-slice CT angiography to guide interventional treatment of hepatic tumor.