The Clinical Study on Hepatic Vessels with 64-slice Spiral Computed Tomography Angiography
|School||Anhui Medical University,|
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||Liver Angiography Fault X - ray computed|
The background and purpose of multislice CT angiography (multi-slice spiral CT angiography, MSCTA) is emerging in recent years developed a noninvasive vascular imaging technology, comprehensive utilization of CT volume data acquisition and three-dimensional recombinant technology. Because of its quick and easy, high image quality, has been widely applied to the whole body. In liver scan, MSCTA mainly applied to the hepatic artery, portal and hepatic venous imaging. Traditional digital subtraction angiography (digital subtraction angiography DSA) display and evaluation of vascular lesions of the \inspection. In recent years, with the development of spiral CT, CTA has become a hot research topic in imaging, has a non-invasive, fast, convenient, etc., at home and abroad on liver MSCTA of many reports, but the clinical value and DSA, there is a considerable gap application of 64-slice spiral CT hepatic angiography study also rare. To this end, we apply the 64-slice spiral CT hepatic angiography study aims to: 1. Explore the 64-slice spiral CT multi-phase hepatic angiography processing technology shows the ability of the liver blood vessels and its clinical value; 2. Investigate liver arterial variation, to better guide intervention; 3 and DSA explore the value of 64-slice spiral CT hepatic angiography in liver blood vessels and rich vascular lesions. Materials and Methods enhanced scan in patients with more than 209 cases of liver, the hepatic arterial phase, portal venous phase dual angiography, minimum thin layer reorganization of the original image data in all cases scanned and transmitted to ADW workstation, ADW workstation on acquisition hepatic angiography thin layer image data were hepatic arterial and portal venous phase angiography 3D reorganization, restructuring include: maximum intensity projection (maximum intensity projection MIP), volume rendering technology (volume rendering VR) and multi-planar reconstruction technique (multiple planar reformation MPR), analysis of three recombinant methods of hepatic artery, portal venous system, hepatic vein, and liver tumor vascular lesions appear. The same period 30 cases of patients with hepatic arterial DSA imaging and controlled observation. Results angiography of the hepatic arterial phase clearly show the celiac artery and its branches go line with the variation, the variation of the hepatic artery in this group was 32%. VR and MIP two recombinant technology display below two of the hepatic artery branch and tumor feeding artery was no significant difference in the hepatic artery branch and tumor blood vessels in more than three significant difference (P lt; 0.05), MIP display was significantly higher than the VR; DSA, 30 patients underwent liver cancer patients, MSCTA DSA is fully consistent feeding arteries and tumor vasculature display on the display of the three following hepatic artery was not statistically significant, in the more than four there are differences in the display of the hepatic artery (P lt; 0.05), DSA is superior to MSCTA; the portal vein period MSCTA can display normal intrahepatic portal and hepatic veins 5 to 6 branch or branches of VR and MIP Both techniques show the portal vein hepatic vein branch or branches of no statistical significance. 97 cases selected for the study of the portal vein, a branch of the portal vein There are five types of variation, variation was 27.8%. The normal group hepatic vein type Ⅰ 80 cases (95%), type II in 4 cases (5%), seven cases seen right after the next hepatic vein, the display rate of 8.3%. The liver artery - portal fistula incidence of 16.3%, portal vein thrombosis was 30.6%; 35 patients with liver cirrhosis (combined HCC except), 29 cases of portal vein the trunk thickening branch to reduce the left gastric vein in 19 cases, esophageal veins, varices, 2 patients with portal vein sponge-like change; eight cases of hepatic hemangioma, 4 patients showed feeding arteries; hepatic focal nodular hyperplasia, the feeding arteries clear display. Conclusion 1. Compared with the previous spiral CT, 64-slice spiral CT hepatic angiography is more accurate and all-round display of hepatic artery and portal vein, hepatic venous system and liver tumors, liver vascular lesions in the liver of tiny blood vessels show significant improvement able to fully meet the clinical needs, and to provide accurate information for preoperative surgical and interventional. Completely replace DSA 2.VR, MIP and MPR recombinant technology used in conjunction diagnosis of vascular lesions in the liver and liver vascular lesions preferred screening method. Hepatic artery with a higher mutation rate, preoperative multislice spiral CTA comprehensive understanding of the hepatic artery and portal vein and the hepatic vein running and variation, which has an important role in guiding interventional treatment and liver transplantation.