计算机断层血管造影术在胃癌患者中检测胃下动脉起源的应用。

Computed Tomography Arteriography for Detecting the Origin of the Inferior Pyloric Artery in Patients with Gastric Cancer.

机构信息

Department of Radiology, Peking University Cancer Hospital & Institute; Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, China.

Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute; Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, China.

出版信息

Korean J Radiol. 2019 Mar;20(3):422-428. doi: 10.3348/kjr.2018.0270.

DOI:10.3348/kjr.2018.0270

PMID:30799573

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6389803/

Abstract

OBJECTIVE

To analyze the detection rate of the inferior pyloric artery (IPA) in patients with gastric cancer by computed tomography arteriography (CTA).

MATERIALS AND METHODS

Fifty-four patients (48 males and 6 females; mean age, 59.0 ± 1.5 years) who had undergone radical gastrectomy for gastric cancer from September 2016 to July 2017 at our institution were recruited prospectively. Patients underwent abdominal contrast-enhanced CT scans and CTA imaging reconstruction before the operation. The origin of the IPA in all cases was determined by a radiologist based on CTA images and verified by the surgeon. The accuracy of CTA in diagnosing the origin of the IPA was calculated. Dominant vessels of the origin were analyzed.

RESULTS

IPAs were detected by CTA in 51 patients (94.4%). Among these, IPAs originated from the right gastroepiploic artery (RGEA) (24 cases), the gastroduodenal artery (GDA) (4 cases), and the anterior superior pancreaticoduodenal artery (ASPDA) (20 cases). In the remaining 3 cases, the IPAs contained two branches originating from the RGEA and ASPDA, respectively. During surgery, in 2 (3.7%) of the 54 cases of gastric cancer, IPAs could not be detected; the IPAs originated from the RGEA (22 cases), GDA (5 cases), and ASPDA (24 cases). One case had an IPA originating from both the RGEA and the GDA. Finally, the accuracy of CTA in diagnosing the origin artery of the IPA was 85.2% (46/54).

CONCLUSION

CTA can detect the origin of the IPA accurately, which can aid surgeons while performing pylorus-preserving operations.

摘要

目的

分析计算机断层血管造影术（CTA）检测胃癌患者下胃动脉（IPA）的检出率。

材料与方法

本研究前瞻性纳入 2016 年 9 月至 2017 年 7 月于我院行根治性胃癌切除术的 54 例患者（男 48 例，女 6 例；平均年龄 59.0±1.5 岁）。所有患者术前均行腹部增强 CT 扫描和 CTA 图像重建。由放射科医生根据 CTA 图像确定 IPA 的起源，并由外科医生验证。计算 CTA 诊断 IPA 起源的准确性。分析起源的优势血管。

结果

51 例（94.4%）患者通过 CTA 检测到 IPA。其中，IPA 起源于右胃网膜动脉（RGEA）（24 例）、胃十二指肠动脉（GDA）（4 例）和前上胰十二指肠动脉（ASPDA）（20 例）。在其余 3 例中，IPA 分别包含起源于 RGEA 和 ASPDA 的两个分支。在 54 例胃癌手术中，有 2 例（3.7%）未检测到 IPA；IPA 起源于 RGEA（22 例）、GDA（5 例）和 ASPDA（24 例）。1 例 IPA 起源于 RGEA 和 GDA。最终，CTA 诊断 IPA 起源动脉的准确性为 85.2%（46/54）。