CAJ | 학술논문

目的探讨采用二维彩色编码DSA技术评估经导管动脉化疗栓塞最佳状态的价值.方法回顾性分析确诊为肝癌,接受经导管动脉化疗栓塞术(TACE)治疗,并采用二维彩色编码DSA(2D-ccDSA)技术进行后处理的24例患者.患者TACE术前、后均行DSA检查,采用DSA彩色编码软件生成二维彩色编码图像和时间密度曲线(TDC).测量导管口、肿瘤供血动脉起点和供血动脉栓塞部位以及肿瘤的达峰时间(TTP),肿瘤血供时间和肿瘤区域TDC最大峰值,并计算栓塞术后肿瘤血供延迟时间.TACE术前、后各参数值的比较采用配对t检验.结果 TACE前导管口和肿瘤供血动脉起点的TTP分别为(3.47 ±0.96)和(4.09±1.09)s,TACE后上述位置的TTP分别为(3.49±1.02)和(3.78±1.05)s,差异无统计学意义(t分别为0.10和1.15,P值分别为0.92和0.26).TACE前、后供血动脉栓塞部位的TTP分别为(4.62±1.16)和(5.59±1.57)s,肿瘤血供时间分别为(0.52±0.41)和(1.82±1.10)s,峰值分别为(3.03±0.88)和(1.10±0.67)灰度单位,差异均有统计学意义(t分别为3.32、6.04和8.93,P均＜0.01).栓塞术后肿瘤血供延迟时间为(1.30±1.05)s.结论二维彩色编码DSA技术可为TACE术最佳状态提供客观且可行的测量指标.
목적 탐토채용이유채색편마DSA기술평고경도관동맥화료전새최가상태적개치.방법 회고성분석학진위간암,접수경도관동맥화료전새술(TACE)치료,병채용이유채색편마DSA(2D-ccDSA)기술진행후처리적24례환자.환자TACE술전、후균행DSA검사,채용DSA채색편마연건생성이유채색편마도상화시간밀도곡선(TDC).측량도관구、종류공혈동맥기점화공혈동맥전새부위이급종류적체봉시간(TTP),종류혈공시간화종류구역TDC최대봉치,병계산전새술후종류혈공연지시간.TACE술전、후각삼수치적비교채용배대t검험.결과 TACE전도관구화종류공혈동맥기점적TTP분별위(3.47 ±0.96)화(4.09±1.09)s,TACE후상술위치적TTP분별위(3.49±1.02)화(3.78±1.05)s,차이무통계학의의(t분별위0.10화1.15,P치분별위0.92화0.26).TACE전、후공혈동맥전새부위적TTP분별위(4.62±1.16)화(5.59±1.57)s,종류혈공시간분별위(0.52±0.41)화(1.82±1.10)s,봉치분별위(3.03±0.88)화(1.10±0.67)회도단위,차이균유통계학의의(t분별위3.32、6.04화8.93,P균＜0.01).전새술후종류혈공연지시간위(1.30±1.05)s.결론 이유채색편마DSA기술가위TACE술최가상태제공객관차가행적측량지표.
Objective To objectively evaluate the endpoint ot transcatheter arterial chemoembolization (TACE) using two dimensional color-coded digital subtraction angiography (2D-ccDSA).Methods Retrospective analysis of twenty-four patients diagnosed with hepatocellular carcinoma (HCC),treated by TACE and evaluated by post-processed 2D-ccDSA.All patients were examined by DSA before and after TACE procedure,all these DSA series were converted into color-code images,the time density curve (TDC) was derived from the 2D-ccDSA imaging.Time-to-peak (TTP) was measured for the ostia of the catheter,the origin of the tumor feeding artery (TFA) and the embolized site of the TFA; maximal TDC enhancement was measured for selected spots of the tumor parenchyma.The tumor blood supply time (TBST) for pre and post-TACE was calculated accordingly.Data were interpreted with paired t test using SPSS.Results The TTP of the ostia of the catheter and the origin of the tumor feeding artery (TFA) before TACE were (3.47 ± 0.96) and (4.09 ± 1.09) s,after the TACE were (3.49 ± 1.02) and (3.78 ± 1.05) s,respectively.There was no statistical difference between the pre-and post-procedural TTP of the two landmarks (t values were 0.10 and 1.15,P values were 0.92 and 0.26).TTP at the embolized site of the main TFA were [(4.62± 1.16) and (5.59± 1.57)s]for pre and post-TACE,the tumor blood supply time (TBST) was greatly delayed compared with that after the TACE procedure [(1.82± 1.10)s and (0.52±0.41)s].The mean maximal TDC enhancements of the tumor parenchyma areas were (3.03±0.88)units before TACE and (1.10±0.67)units after TACE.The differences were all statistically significant (t values were 3.32,6.04 and 8.93,respectively,P＜0.01) Conclusion It is feasible to use 2D-ccDSA to objectively assess the endpoint of TACE procedures.