nav emailalert searchbtn searchbox tablepage yinyongbenwen piczone journalimg journalInfo journalinfonormal searchdiv searchzone qikanlogo popupnotification paper paperNew
2017, 09, v.36 3616-3621
基于CBCT的三维重建技术在原发性肝癌TACE治疗中的应用
基金项目(Foundation): 河北医科大学第四医院资助
邮箱(Email):
DOI: 10.13417/j.gab.036.003616
摘要:

为了深入了解基于CBCT的三维重建技术在原发性肝癌TACE治疗中的应用,本研究对在我院进行TACE治疗的原发性肝癌患者,分别采用基于CBCT的三维重建技术和常规的DSA技术进行分析比较。我们选取我院2013年1月~2015年10月确诊的67例原发性肝癌患者,采用随机数字表法分为CBCT组34例、血管造影(DAS组)33例,两组均采用TACE治疗,术中分别给予CBCT及三维重建、DSA技术进行手术指指导。研究表明:CBCT组对肿瘤供血动脉检出正确率、超选择动脉插管成功率、碘油在病灶中完全沉积率均高于DSA组(p<0.05);CBCT组的手术时间、辐射总剂量均高于DSA组(p<0.05);术后一个月复查,CBCT组CR 17.65%、PR 73.53%、SD 8.82%,DSA组CR 6.06%、PR 66.67%、SD 21.21%、PD 6.06%,两组比较差异具有统计学意义(p<0.05);术后一个月复查,CBCT组血清AFP水平低于DSA组(p<0.05);两组患者的KPS评分较本组术前均显著的提高(p<0.05),两组间的KPS评分差异无统计学意义(p>0.05)。我们的研究初步得出结论:基于CBCT的三维重建技术在原发性肝癌TACE治疗中较DSA技术能够更好的检出肿瘤的供血动脉、指导手术更加便捷和精确,能达到更好的手术效果。

Abstract:

In order to further understand the application of 3D reconstruction technology based on CBCT in the transcatheter arterial chemoembolization(TACE) treatment of primary liver cancer,the patients suffered from primary liver cancer who had received TACE treatment in our hospital were analyzed and compared by 3D reconstruction operation based on cone beam CT(CBCT) and conventional DSA technique.We selected 67 patients with primary liver cancer diagnosed in our hospital from January 2013 to October 2015,and divided them into CBCT group of 34 cases and angiography(DAS group) of 33 cases by random number table method.Both groups received TACE treatment,but one group received CBCT and 3D reconstruction and the other received DSA technology during the operation as constructions.The results showed that the detection accuracy rate of the tumor feeding artery,success rate of super selective arterial intubation,and the complete deposition rate of iodine oil in the lesions of CBCT group were all higher than those of DSA group(p<0.05).Operation time and total radiation dose of CBCT group were higher than those of DSA group(p <0.05).The check in one month after surgery showed that the CR,PR and SD of CBCT group were 17.65%,73.53% and 8.82%,respectively,but for DSA,PRwas 66.67%,SD was 21.21%,PD and CR were both 6.06%.The differences between the two groups had no statistical significance(p<0.05).The check in one month after surgery demonstrated that serum AFP level of CBCT group was lower than that of DSA group(p<0.05).The KPS scores of the two groups were obviously higher than before(p<0.05),while the difference in KPS score between the two groups was not statistically significant(p>0.05).In conclusion,our study preliminarily summarized that the 3D reconstruction technique based on CBCT could detect the blood supply artery of tumor better than DSA technology in TACE treatment of primary liver cancer.It could guide the operation to be more convenient and accurate,so as to achieve better operation results.

参考文献

Gao L.,Shao H.B.,Ma T.C.,Ni E.H.,Wu W.Y.,Su H.Y.,and Xu K.,2015,Cone-beam CT with three-dimensional reconstruc tion techniques versus conventional digital subtraction an giography in transcatheter arterial chemoembolization o hepatocellular carcinoma,Yingxiang Zhenduan Yu Jieru Fangkexue(Diagnostic Imaging&Interventional Radiolo gy),24(1):29-33(高龙,邵海波,马腾闯,倪尔会,吴文颖苏洪英,徐克,2015,锥形束CT联合三维重建技术与传统的血管造影在肝动脉化疗栓塞术中的比较研究,影像诊断与介入放射学,24(1):29-33)

Kudo M.,Izumi N.,Ichida T.,Ku Y.,Kokudo N.,Sakamoto M.Takayama T.,Nakashima O.,Matsui O.,and Matsuyama Y.20 16,Report of the 19th follow-up survey of primary live cancer in Japan,Hepatology Research,46(5):372-390

Lin Y.H.,Zhang B.Y.,Li X.F.,Liu D.X.,Zhou Z.P.,Hong B.Z.Ye C.P.,and Huang Q.M.,2015,Application value o three-dimensional reconstruction technique of rotational dig ital subtraction angiorap hy in interventional treatment fo liver cancer,Zhongguo Yixue Wulixue Zazhi(Chinese Jour nal of Medical Physics),32(6):851-854(林拥华,章宝燕李新丰,刘德鑫,周志平,洪本祖,叶超平,黄启明,2015肝癌介入治疗中旋转数字减影血管造影三维重建技术的应用价值,中国医学物理学杂志,32(6):851-854)

Liu H.D.,Ding G.,Zhang M.,Jiang F.,Yuan C.T.,Liang H.X.Xu J.D.,Ni Y.,Liao Z.J.,Huang J.,and Huang Y.,2015,Ef ficacy combined transcatheter arterial chemoembolization(TACE)and radiotherapy for advanced primary liver cancer Xiandai Zhongliu Yixue(Journal of Modern Oncology),23(9):1258-1261(刘合代,丁罡,张明,姜峰,袁翠堂,梁洪享徐菊娣,倪裕,廖志军,黄骞,黄燕,2015,肝动脉栓塞化疗联合放疗治疗原发性肝癌的疗效分析,现代肿瘤医学,23(9):1258-1261)

Ry erson A.B.,Eheman C.R.,Altekruse S.F.,Ward J.W.,Jemal ASherman R.L.,Henley S.J.,Holtzman D.,Lake A.,Noone AM.,Anderson R.N.,Ma J.M.,Ly K.N.,Cronin K.A.,Pen berthy L.,and Kohler B.A.,2016,Annual report to the na tion on the status of cancer,1975-2012,featuring the in creasing incidence of liver cancer,Cancer,122(9):1312-1337

Wang Y.,He L.,Du Y.,Zhu P.,Huang G.,Luo J.,Yan X.L.,Ye B.Q.,Li C.,Xia P.Y.,Zhang G.,Tian Y.,Chen R.S.,and Fan Z.S.,2015,The long noncoding RNA lnc TCF7 pro motes self-renewal of human liver cancer stem cells through activation of Wnt signaling,Cell Stem Cell,16(4):413-425

Yang P.M.,and Xu H.Y.,2015,Efficacy analysis of oxallplatin combined with TACE in treatment of hepatocellular carcino ma,Ganzang(Chinese Hepatolgy),20(4):281-284(杨培民徐洪燕,2015,奥沙利铂联合TACE治疗原发性肝癌疗效分析,肝脏,20(4):281-284)

Yang Y.B.,Jiang L.,Ding G.J.,Sun S.,and Shao G.L.,2017Postoperative adjuvant TACE can prevent the early occur rence of lung metastasis in hepatocellar carcinoma patients Xiandai Zhongliu Yixue(Journal of Modern Oncology),25(2):241-245(杨永波,蒋来,丁国军,孙松,邵国良,2017肝细胞肝癌术后辅助性TACE治疗可降低肺转移风险现代肿瘤医学,25(2):241-245)

Yang Z.,2015,Effect of three dimensional conformal radiation therapy combined with transcatheter arterial chemoe-mbolization in the treatment of primary liver cancer,Zhongguo Yixue Qianyan Zazhi(Chinese Journal of the Frontiers o Medical Science(Electronic Version)),7(10):56-58(杨哲2015,三维适形放疗联合经导管肝动脉化疗栓塞治疗原发性肝癌临床效果分析,中国医学前沿杂志,7(10):56-58)

Zh an C.L.,2016,Logistic regression analysis of risk factors o hepatitis cirrhosis(HC)complicated with hepatocellula car-cinoma(HCC),Yixue Linchuang Yanjiu(Journal o Clinical Research),33(9):1697-1701(占春玲,2016,乙肝肝硬化并发原发性肝癌危险因素的logistic回归分析,医学临床研究,33(9):1697-1701)

Zhou X.D.,and Tang Z.Y.,2015,Cryotherapy for primary live cancer,In Seminars in Surgical Oncology,14(2):171-174

基本信息:

DOI:10.13417/j.gab.036.003616

中图分类号:R730.44;R735.7

引用信息:

[1]谢宝杰,朱丽娜,张凤娟,等.基于CBCT的三维重建技术在原发性肝癌TACE治疗中的应用[J].基因组学与应用生物学,2017,36(09):3616-3621.DOI:10.13417/j.gab.036.003616.

基金信息:

河北医科大学第四医院资助

发布时间:

2017-09-25

出版时间:

2017-09-25

检 索 高级检索