Lee In Joon, Chung Jin Wook, Yin Yong Hu, Kim Hyo-Cheol, Kim Young Il, Jae Hwan Jun, Park Jae Hyung
Department of Radiology, National Cancer Center, Goyang-si Gyeonggi-do; Department of Radiology, Seoul National University College of Medicine, Seoul.
Department of Radiology, Seoul National University College of Medicine, Seoul; Institute of Radiation Medicine, Seoul National University Medical Research Center, Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Chongno-gu, Seoul, 110-744, Republic of Korea.
J Vasc Interv Radiol. 2014 Sep;25(9):1369-79; quiz 1379-.e1. doi: 10.1016/j.jvir.2014.04.011. Epub 2014 Jun 10.
To analyze image quality and the factors that determine it for cone-beam computed tomography (CT) hepatic arteriography in chemoembolization for hepatocellular carcinoma (HCC).
From September 2009-December 2010, 399 consecutive patients referred for chemoembolization of HCC were scheduled for cone-beam CT scan. There were 12 patients (3%) excluded because of difficulty with breath-hold. Of the 387 patients who underwent cone-beam CT hepatic arteriography, 100 patients were ultimately included in the study according to inclusion criteria. Maximum intensity projection images were scored for image quality of each segmental hepatic artery. Potential determining factors for image quality were diaphragmatic motion, portal vein enhancement, and hepatic artery-to-parenchyma enhancement ratio. The flow rate of contrast media, x-ray delay, and location of the catheter tip were also evaluated.
It was possible to trace at least subsegmental hepatic arteries in 625 of 700 segments (89.3%) on cone-beam CT hepatic arteriography. Diaphragmatic motion, prominent portal vein enhancement, and low hepatic artery-to-parenchyma enhancement ratio worsened image quality (P < .001, P = .022, and P = .017). Owing to cardiac motion artifacts, image quality of the left lateral segments (S2 and S3) was poorer compared with the remaining hepatic segments (S4-S8).
In most cases, the quality of cone-beam CT hepatic arteriography images was good enough to trace subsegmental hepatic arteries at a minimum. Respiratory and cardiac motion, portal vein enhancement, and hepatic artery-to-parenchyma enhancement ratio significantly affected the image quality of cone-beam CT hepatic arteriography.
分析在肝细胞癌（HCC）化疗栓塞中，锥形束计算机断层扫描（CT）肝动脉造影的图像质量及其决定因素。
2009年9月至2010年12月，399例连续转诊接受HCC化疗栓塞的患者计划进行锥形束CT扫描。因屏气困难排除12例患者（3%）。在387例接受锥形束CT肝动脉造影的患者中，根据纳入标准最终有100例患者纳入研究。对每个肝段动脉的最大强度投影图像进行图像质量评分。图像质量的潜在决定因素包括膈肌运动、门静脉强化以及肝动脉与实质强化比值。还评估了造影剂流速、X线延迟和导管尖端位置。
在锥形束CT肝动脉造影上，700个肝段中的625个（89.3%）至少可以追踪到亚段肝动脉。膈肌运动、显著的门静脉强化和低肝动脉与实质强化比值会使图像质量变差（P <.001、P =.022和P =.017）。由于心脏运动伪影，与其余肝段（S4 - S8）相比，左外侧段（S2和S3）的图像质量较差。
在大多数情况下，锥形束CT肝动脉造影图像质量足以至少追踪到亚段肝动脉。呼吸和心脏运动、门静脉强化以及肝动脉与实质强化比值显著影响锥形束CT肝动脉造影的图像质量。
