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骨盆骨肿瘤术前栓塞中应用自动骨减影的锥形束 CT。

Cone-beam computed tomography with automated bone subtraction in preoperative embolization for pelvic bone tumors.

机构信息

Department of Radiology, Seoul National University Hospital, Seoul, Korea.

出版信息

PLoS One. 2017 Apr 18;12(4):e0175907. doi: 10.1371/journal.pone.0175907. eCollection 2017.

Abstract

PURPOSE

To evaluate the usefulness of cone-beam computed tomography with automated bone subtraction (CBCT-ABS) in the preoperative embolization of hypervascular tumors located in the pelvic bone.

MATERIALS AND METHODS

This retrospective study included 26 patients with pelvic bone tumors who underwent preoperative embolization between January 2014 and October 2016. A CBCT-ABS scan was taken in a total of 17 patients (CBCT-ABS group), and only a series of digital subtraction angiographies (DSAs) was taken in the remaining 9 patients (DSA group). The percent devascularization, number of angiographic runs, total dose-area product (DAP), fluoroscopy time, interventional procedure time, operative time, and estimated blood loss were compared between the two groups using Mann-Whitney test.

RESULTS

The percent devascularization, interventional procedure time, fluoroscopy time, operative time, and estimated blood loss were not statistically different between the two groups (p > 0.05). On the other hand, the number of angiographic runs in the CBCT-ABS group was significantly lower than that in the DSA group (p = 0.029). The total DAP of the CBCT-ABS group (mean, 17700.7 μGym2) was higher than that of the DSA group (mean, 8939.4 μGym2) (p = 0.002).

CONCLUSIONS

The use of CBCT-ABS during the preoperative embolization of pelvic bone tumors significantly reduces the number of angiographic runs at the cost of an increased radiation dose.

摘要

目的

评估锥形束 CT 自动骨减影(CBCT-ABS)在骨盆内富血管肿瘤术前栓塞中的应用价值。

材料与方法

本回顾性研究纳入了 2014 年 1 月至 2016 年 10 月期间接受骨盆肿瘤术前栓塞的 26 名患者。共对 17 名患者进行了 CBCT-ABS 扫描(CBCT-ABS 组),而对其余 9 名患者仅进行了一系列数字减影血管造影(DSA)(DSA 组)。采用 Mann-Whitney 检验比较两组间的血管化百分比、血管造影运行次数、总剂量面积乘积(DAP)、透视时间、介入手术时间、手术时间和估计失血量。

结果

两组间的血管化百分比、介入手术时间、透视时间、手术时间和估计失血量无统计学差异(p>0.05)。另一方面,CBCT-ABS 组的血管造影运行次数明显少于 DSA 组(p=0.029)。CBCT-ABS 组的总 DAP(均值,17700.7 μGym2)高于 DSA 组(均值,8939.4 μGym2)(p=0.002)。

结论

在骨盆肿瘤术前栓塞中使用 CBCT-ABS 可显著减少血管造影运行次数,但代价是辐射剂量增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20b9/5395210/623f36408e8a/pone.0175907.g001.jpg

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