Takada Ken, Toyoda Hidenori, Tada Toshifumi, Ito Takanori, Hasegawa Ryohei, Gotoh Tatsuya, Ichikawa Hironori, Sone Yasuhiro, Kumada Takashi
Department of Medical Technology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan.
Department of Gastroenterology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan.
J Gastroenterol. 2015 Dec;50(12):1190-6. doi: 10.1007/s00535-015-1065-0. Epub 2015 Mar 21.
Transarterial chemoembolization (TACE) is an important treatment modality for hepatocellular carcinoma (HCC). Accurate identification of feeding arteries and catheterization are necessary for achieving treatment efficacy, especially with selective TACE. However, this often requires multiple imaging studies. We evaluated the utility of a newly developed apparatus that combines multidetector-row computed tomography (MDCT) and angiography (angio-MDCT) to facilitate TACE for treatment of HCC.
A total of 73 patients who underwent selective TACE with angio-MDCT were compared with 57 patients who had undergone selective TACE with single-row computed tomography assisted by angiography (angio-CT) in terms of the number of imaging studies needed to complete TACE.
The mean number of digital subtraction arteriography (DSA) and CT studies required for characterization of feeding arteries before embolization was 3.53 (range 1-8) and 5.16 (range 2-11), respectively, with single-row angio-CT, and 1.67 (range 1-5) and 2.90 (range 1-5), respectively, with angio-MDCT. Fewer studies were needed in patients who underwent TACE with angio-MDCT (p < 0.0001 for both DSA and CT). Whereas single-row angio-CT failed to identify extrahepatic feeders in three patients (37.5%), all extrahepatic feeders could be identified with angio-MDCT.
Angio-MDCT facilitates rapid and accurate identification of feeding arteries in patients undergoing TACE through the three-dimensional image analyses by the reconstruction with the workstation.
经动脉化疗栓塞术（TACE）是肝细胞癌（HCC）的一种重要治疗方式。准确识别供血动脉并进行插管对于实现治疗效果至关重要，尤其是在选择性TACE中。然而，这通常需要进行多项影像学检查。我们评估了一种新开发的将多排螺旋计算机断层扫描（MDCT）与血管造影术（血管造影-MDCT）相结合的设备在促进TACE治疗HCC方面的效用。
将73例行血管造影-MDCT选择性TACE的患者与57例行血管造影辅助单排计算机断层扫描（血管造影-CT）选择性TACE的患者在完成TACE所需的影像学检查数量方面进行比较。
在单排血管造影-CT组中，栓塞前确定供血动脉特征所需的数字减影血管造影（DSA）和CT检查的平均次数分别为3.53次（范围1-8次）和5.16次（范围2-11次），而在血管造影-MDCT组中分别为1.67次（范围1-5次）和2.90次（范围1-5次）。血管造影-MDCT组进行TACE的患者所需检查较少（DSA和CT均p<0.0001）。单排血管造影-CT未能识别出3例患者（37.5%）的肝外供血动脉，而血管造影-MDCT能够识别所有肝外供血动脉。
血管造影-MDCT通过工作站重建进行三维图像分析，有助于在接受TACE的患者中快速准确地识别供血动脉。
