目的：探讨640层容积CT 4D-DSA技术评价肝癌门静脉病变异及的应用价值。方法回顾分析2012年5月—2015年5月该院确诊的80例肝癌患者640层容积CT 4D-DSA技术检查影像资料。将获得的所有容积数据导入后处理工作站,选择肝门静脉显示最佳的图像分析肝癌门静脉病变。选择80名患者三期肝脏增强扫描后所受辐射剂量进行对比。结果共有80例图像质量符合标准,存在门静脉双重供血动脉4例,80例患者中门静脉病变的36例,单纯肝动脉-门静脉瘘6例(占16.6%),单纯门静脉癌栓7例(占19.4%),肝动脉-门静脉瘘合并门静脉癌栓18例(占50%),门静脉闭塞5例(占13.8%),门静脉癌栓阻塞合并门静脉海绵样变3(占8.3%)。两种检查序列辐射剂量的有效剂量ED分别为10.539 mSv、23.159 mSv,对比结果,差异具有统计学意义P<0.05。结论640层容积CT的低辐射剂量、高清晰模仿DSA图像能应用与肝癌门静脉病变的诊断,并有助于治疗方案和预后的评价。%Objective To explore the application value of 640 slice volume 4D-DSA CT technique in the evaluation of hepatic portal vein disease variation Methods A retrospective analysis of 80 cases of hepatocellular carcinoma in our hospital from May 2012 to May 2015 was diagnosed by 640 slice volume 4D-DSA CT technique. Male 41 cases, female 39 cases, age 40~72 years old, average age (58.5±5.9) years old. All the volume data were imported into the post pro-cessing station, and the data were processed according to the time order. Selection of hepatic portal vein to display the best image analysis of hepatic portal vein lesion. The radiation doses were compared between 80 patients with stage three liver enhancement scan. Results A total of 80 patients with image quality conforms to the standard, there portal double blood supply artery in 4 cases. Including 36 patients with portal vein diseases, simple hepatic artery portal vein fistula in 6 cases (16.6%), simple tumor thrombi in the portal vein 7 cases (19.4%), hepatic artery portal vein fistula complicated with portal vein tumor thrombus in 18 cases (50%) and portal vein occlusion in 5 cases (13.8%), portal vein tumor thrombus occlusion with portal vein cavernous transformation of 3 cases (8.3%). The effective dose of radia-tion dose of the two kinds of test sequences was 10.539 mSv and 23.159 mSv,compared to the sets of results, showing the difference with statistical significanceP<0.05. Conclusion The low radiation dose of 640 slice volume CT, high definition DSA image can be used in the diagnosis of hepatic portal vein disease, and it is helpful to the treatment plan and prognosis.
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