Kinoshita Mitsuhiro, Shirono Ryozo, Takechi Katsuya, Yonekura Hironobu, Iwamoto Seiji, Shinya Takayoshi, Takao Shoichiro, Harada Masafumi
Department of Radiology (Diagnostic Radiology), Tokushima University Hospital, 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
Department of Radiology, Tokushima Red Cross Hospital, 103 Irinokuchi Komatsushima-cho, Komatsushima City, Tokushima, 773-8502, Japan.
Cardiovasc Intervent Radiol. 2017 Jun;40(6):894-901. doi: 10.1007/s00270-017-1581-9. Epub 2017 Jan 26.
To retrospectively evaluate the usefulness of virtual fluoroscopic preprocedural planning (VFPP) in the percutaneous transhepatic biliary drainage (PTBD) procedure.
Twenty-two patients who were treated by PTBD were included in this study. Twelve patients were treated using PTBD intraoperative referencing coronal computed tomography (CT) images (i.e., coronal CT group), and ten patients were treated using PTBD intraoperative referencing VFPP images (i.e., VFPP group). To analyze the effect of the intraoperative referencing VFPP image, the VFPP group was retrospectively compared with the coronal CT group.
The characteristics of both patient groups were not statistically significantly different. There were no significant differences in the targeted bile duct, diameter and depth of the target bile, breath-holding ability, number of targeted bile duct puncture attempts, change in the targeted bile duct, and exchange of the drainage catheter. However, the X-ray fluoroscopy time and the procedure time were significantly shorter in the VFPP group than in the coronal CT group (196 vs. 334 s, P < 0.05; and 16.0 vs. 27.2 min, P < 0.05).
Intraoperative referencing using the VFPP imaging in PTBD intuitively can be a useful tool for better localization of the guidewire in the bile duct and thereby shorten the X-ray fluoroscopy time and procedure time while minimizing radiation exposure and complications.
回顾性评估虚拟荧光透视术前规划(VFPP)在经皮经肝胆道引流(PTBD)手术中的实用性。
本研究纳入了22例行PTBD治疗的患者。12例患者在PTBD术中参考冠状位计算机断层扫描(CT)图像进行治疗(即冠状位CT组),10例患者在PTBD术中参考VFPP图像进行治疗(即VFPP组)。为分析术中参考VFPP图像的效果,将VFPP组与冠状位CT组进行回顾性比较。
两组患者的特征在统计学上无显著差异。在目标胆管、目标胆汁的直径和深度、屏气能力、目标胆管穿刺尝试次数、目标胆管变化以及引流导管更换方面均无显著差异。然而,VFPP组的X线透视时间和手术时间明显短于冠状位CT组(196秒对334秒,P<0.05;16.0分钟对27.2分钟,P<0.05)。
在PTBD术中使用VFPP成像进行术中参考,直观上可成为一种有用的工具,有助于更好地在胆管中定位导丝,从而缩短X线透视时间和手术时间,同时将辐射暴露和并发症降至最低。