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目的探讨多排螺旋CT血管显像技术(CTA)对肝脏肿瘤性病变的肝动脉、门静脉系统的显示特点及其临床意义。方法对肝脏肿瘤性病变临床资料完整的患者119例行64排螺旋CT动脉期及门静脉期扫描,分别行最大密度造影(MIP),表面遮盖显示(SSD),容积再现技术(VR)3种方法重建,比较多排螺旋CTA对肝动脉、门静脉的显示情况,以及对术中出血风险的评估。结果肝动脉VI级显示MIP与VR对比无统计学差异(P>0.05)均优于SSD法(P<0.05);3种重建技术对于门静脉I,II,III级分支均显示良好,显示率都在98.1%以上(P>0.05)。CTA预测术中出血风险较小的准确率为96.7%,出血风险较大的准确率为90.5%,两者有统计学差异(P<0.05)。结论肝脏多排螺旋CTA血管显像技术可以满足临床的需求,MIP与VR联合应用对肝动脉和门静脉显示效果最佳,SSD亦具有良好的辅助作用;CTA可以初步预测术中出血的风险。
Objective To investigate the characteristics and clinical significance of multi-slice spiral CT angiography (CTA) on the hepatic artery and portal vein in patients with liver neoplasm. Methods Thirty-nine patients with clinically complete liver neoplasm were scanned with 64-slice spiral CT in arterial phase and portal venous phase. MIP, SSD and volumetric VR were performed respectively. Reconstruction, multi-row spiral CTA on the hepatic artery, portal vein display, as well as the assessment of intraoperative bleeding risk. Results The level of hepatic artery VI showed no significant difference between MIP and VR (P> 0.05), but the three methods were superior to those of SSD (all P <0.05) More than 98.1% (P> 0.05). The accuracy of CTA in predicting the lower bleeding risk during surgery was 96.7%, and the accuracy of bleeding was 90.5%. There was a significant difference between the two (P <0.05). Conclusions Multi-slice spiral CTA angiography can meet the clinical needs. Combined application of MIP and VR shows the best effect on the hepatic artery and portal vein and SSD also has a good adjuvant effect. CTA can be used to predict the risk of intraoperative bleeding.