MSCT胃血管成像在腹腔镜及介入治疗胃癌中的应用价值
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摘要
目的探讨在胃癌腹腔镜根治术及胃癌介入治疗中多层螺旋CT(multislice spiral CT,MSCT)针对胃周动静脉血管成像的应用价值。方法搜集在我院80例经病理证实的胃癌患者,治疗前均使用飞利浦256层i CT进行腹部三期增强扫描后,将原始数据重建薄层后传至飞利浦后处理工作站,使用后处理程序容积演示(volume rendering,VR)、曲面重建技术(curved planar reformation,CPR)、薄层最大密度投影法(maximum intensity projectionthin,MIP-Thin)、最大密度投影法(maximum intensity projection,MIP)显示胃及及肿瘤供血血管。结果采用VR、CRP、MIP-Thin、MIP重建技术,可以对胃主要动脉血管起源、走行及变异的情况进行显示分析,但动脉远端细小血管及静脉显示较差。结论 MSCT对胃及肿瘤血管成像技术,可以为临床腹腔镜及介入治疗胃癌提供重要信息。
Objective To study the arteriovenous imaging value of multi-slice spiral CT in the laparoscopic and interventional treatment for gastric cancer. Methods To collect 80 patients with gastric cancer, which were confirmed by pathology in our hospital. abdominal three phases enhanced scan was performed by Philips 256 layer i CT before treatment, the imaging data was sended to post-processing workstation, volume rendering(VR), curved planar reformation(CPR), maximum intensity projection-thin(MIP-Thin), maximum intensity projection(MIP) was used to show stomach and tumor blood vessels by post-processing program. Results Using VR, CRP, MIP-Thin, MIP reconstruction technology, can show the beginning, path and mutation of stomach major blood vessels, but distal small blood vessels is poor to display. Conclusion MSCT of stomach and tumor vascular imaging technology, can provide important information for clinical in laparoscopic and interventional treatment gastric cancer.
Objective To study the arteriovenous imaging value of multi-slice spiral CT in the laparoscopic and interventional treatment for gastric cancer. Methods To collect 80 patients with gastric cancer, which were confirmed by pathology in our hospital. abdominal three phases enhanced scan was performed by Philips 256 layer i CT before treatment, the imaging data was sended to post-processing workstation, volume rendering(VR), curved planar reformation(CPR), maximum intensity projection-thin(MIP-Thin), maximum intensity projection(MIP) was used to show stomach and tumor blood vessels by post-processing program. Results Using VR, CRP, MIP-Thin, MIP reconstruction technology, can show the beginning, path and mutation of stomach major blood vessels, but distal small blood vessels is poor to display. Conclusion MSCT of stomach and tumor vascular imaging technology, can provide important information for clinical in laparoscopic and interventional treatment gastric cancer.
引文
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[2]Horton KM,Fishman EK.Multidetector CT angiography of pancreatic carcinoma:part I,evaluation ofarterial involvement[J].AJR Am J Roentgenol,2002,178(4):827-831.
[3]Horton KM,Fishman EK.Multidetector CT angiography of pancreatic carcinoma:part 2,evaluation ofvenous involvement[J].AJR Am J Ro entgenol,2002,178(4):833-836.
[4]Meyer BC,Werncke T,Hopfenmuller W,et al.Dual energy CT of peripheral arteries:effect of automatic bone and plaque removal on image quality and grading of stenoses[J].Eur J Radiol,2008,68(3):414-422.
[5]Sommer WH,Johnson TR,Becker CR,et al.The value of dual-energy bone removal in maximum intensity projections of lower extremity computed tomography angiography[J].Invest Radiol,2009,44(5):285-292.
[6]李佑,臧潞,胡伟国,等.腹腔镜与开腹胃癌根治术治疗早期胃癌的临床对照研究[J].中华胃肠外科杂志,2010,13(12):899-902.
[7]Usui S,Yoshida T,Ito K,et al.Laparoscopy-assisted total gastrectomy for early gastric cancer:comparison with conventional open total gastrectomy[J].Surg Laparosc Endosc Percutan Tech,2005,15(6):309-314.
[8]李家开,张金山.肝-胃动脉的解剖学基础及其在肝癌经导管动脉内化疗栓塞中的意义[J].中华放射学杂志,2001,35(12):892-897.
[9]罗建光,杨东益.肝动脉螺旋CT血管成像和三维重建的临床应用[J].实用放射学杂志,1999,15(4):201-204.
[10]张帆,孟存良,谷剑,等.经膈下动脉介入化疗栓塞术治疗原发性肝癌[J].实用放射学杂志,2006,22(6):725-727.