CAJ | 학술논문

目的评价多层螺旋CT血管成像(MSCTA)对胰十二指肠切除术前肝动脉的检出价值.方法胰腺癌和壶腹周围肿瘤患者术前均行腹部CT血管成像(CTA),以数字减影血管造影(DSA)和术中所见的肝动脉解剖为金标准进行比较.结果 81例患者纳入本研究,其中29例行DSA评估肿瘤可切除性和动脉灌注化疗,66接受了手术治疗.CTA检测到17例(21％)患者有变异的肝动脉,13例(16.0％)为一根动脉变异,4例(4.9％)为两根动脉变异.按Michels分型,Ⅳ型、Ⅶ和Ⅷ型各1例,MichelsⅢ型和Ⅴ型各2例,5例为MichelsⅥ型,4例为MichelsⅪ型,1例为罕见变异,未包括在Michels分型里.MSCTA的准确率、灵敏度和特异度均为100％.对于每根肝动脉的清晰度评分,MSCTA与DSA的差异无统计学意义.结论 MSCTA可有效评估胰头周围动脉的解剖变异,为胰十二指肠切除术前了解胰周血管结构提供有价值的信息.
목적 평개다층라선CT혈관성상(MSCTA)대이십이지장절제술전간동맥적검출개치.방법 이선암화호복주위종류환자술전균행복부CT혈관성상(CTA),이수자감영혈관조영(DSA)화술중소견적간동맥해부위금표준진행비교.결과 81례환자납입본연구,기중29례행DSA평고종류가절제성화동맥관주화료,66접수료수술치료.CTA검측도17례(21％)환자유변이적간동맥,13례(16.0％)위일근동맥변이,4례(4.9％)위량근동맥변이.안Michels분형,Ⅳ형、Ⅶ화Ⅷ형각1례,MichelsⅢ형화Ⅴ형각2례,5례위MichelsⅥ형,4례위MichelsⅪ형,1례위한견변이,미포괄재Michels분형리.MSCTA적준학솔、령민도화특이도균위100％.대우매근간동맥적청석도평분,MSCTA여DSA적차이무통계학의의.결론 MSCTA가유효평고이두주위동맥적해부변이,위이십이지장절제술전료해이주혈관결구제공유개치적신식.
Objective To assess the value of multi-slice computed tomography angiography (MSCTA) in the preoperative detection of aberrant hepatic arteries in patients scheduled to undergo pancreaticoduodenectomy.Methods Patients with pancreatic and peri-ampullary tumors were preoperatively studied using contrast-enhanced abdominal CT angiography (CTA).The results on hepatic arterial anatomy were compared with those obtained from digital subtraction angiography (DSA) and on surgical findings.Results Eighty-one patients were included into this study.DSA was carried out in 29 patients to evaluate tumor resectability,and 66 patients received surgery.Anomalous hepatic arteries were detected in 17 (21％) patients on CTA.Thirteen (16.0％) patients had a single arterial variant,and 4 (4.9％) patients had two arterial variants.One patient each was seen in the Michels type Ⅳ,Ⅶ,and Ⅷ respectively,while 2 patients each were seen in the Michels type Ⅲ and Ⅴ respectively.Five patients were diagnosed as the Michels type Ⅵ,and four as the Michels type Ⅸ.One patient demonstrated a rare variant which was not included into the Michels classification.MSCTA had an accuracy of 100％,a sensitivity of 100％,and a specificity of 100％.Regarding the traceability scores of hepatic arterial segment,there were no statistically significant differences between MSCTA and DSA.Conclusions MSCTA is an effective imaging tool to assess arterial anatomical variation around the pancreatic head.It is non-invasive,and it provides valuable information on the peri-pancre atic vascular anatomy before pancreaticoduodenectomy.