Wu Deqing, Zhao Linyong, Liu Ying, Wang Junjiang, Hu Weixian, Feng Xingyu, Lv Zejian, Li Yong, Yao Xueqing
Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
Onco Targets Ther. 2017 Feb 16;10:927-933. doi: 10.2147/OTT.S88330. eCollection 2017.
To evaluate the utilization of 256-slice spiral computed tomography (CT) angiography in preoperative assessment of perigastric vascular anatomy in patients with gastric cancer.
In this study, 80 gastric cancer patients were included. The medical procedure of 256-slice spiral CT angiography was performed on each of these patients consecutively. Thereafter, these patients were subjected to surgical treatment in our hospital. The techniques of volume rendering (VR) and maximum intensity projection (MIP) were used to image reconstruction of arteries around the stomach.
Both VR and MIP were applied to reconstruct the images of perigastric arteries. The results indicated that VR imaging was inferior to MIP in determining the variant small artery anatomy around the greater curvature and fundus. The respective rates of imaging produced by VR and MIP for left gastroepiploic artery, short gastric artery, and posterior gastric artery, were 32.50% versus 100%, 16.25% versus 87.50%, and 3.75% versus 25.00%, respectively. According to Hiatt's classification, 75 out of 240 cases were abnormal types, among which we found Type II in 30 cases, Type III in 33 cases, Type IV in three cases, Type V in six cases, and Type VI in only three cases. There was no significant difference for total and every single variation type, between our group and Hiatt's group (>0.05).
The 256-slice spiral CT angiography can be regarded as an effective and accurate diagnostic modality for preoperative assessing anatomical arterial variations in gastric cancer; MIP was superior to VR at identifying variations of some small artery, whereas VR was better than MIP at showing anatomical arterial variations due to its three-dimensional effect.
评估256层螺旋计算机断层扫描（CT）血管造影术在胃癌患者胃周血管解剖结构术前评估中的应用。
本研究纳入80例胃癌患者。对这些患者依次进行256层螺旋CT血管造影术检查。此后，这些患者在我院接受手术治疗。采用容积再现（VR）和最大密度投影（MIP）技术对胃周围动脉进行图像重建。
VR和MIP均用于重建胃周动脉图像。结果表明，在确定胃大弯和胃底周围变异小动脉解剖结构方面，VR成像不如MIP。VR和MIP对胃网膜左动脉、胃短动脉和胃后动脉的成像率分别为32.50%对100%、16.25%对87.50%和3.75%对25.00%。根据Hiatt分类，240例中有75例为异常类型，其中II型30例，III型33例，IV型3例，V型6例，VI型仅3例。在总体和每种变异类型方面，我们的研究组与Hiatt组之间无显著差异（>0.05）。
256层螺旋CT血管造影术可被视为术前评估胃癌患者解剖性动脉变异的一种有效且准确的诊断方法；在识别某些小动脉变异方面，MIP优于VR，而VR因其三维效果在显示解剖性动脉变异方面优于MIP。
