| 潘国和,郑家平.经球囊导管肝段热凝固CT与病理对照研究[J].浙江中西医结合杂志,2015,25(1): |
| 经球囊导管肝段热凝固CT与病理对照研究 |
| Image Appearance of Hepatic Segmental Ablation By Transcatheter Intraarterial Hyperthermic Infusion |
| 投稿时间：2014-05-20 修订日期：2014-05-20 |
| DOI： |
| 中文关键词: 热灌注 肝脏 热凝固坏死 DSA CT |
| 英文关键词:Hyperthermic perfusion Liver Hyperthermic coagulation necrosis Digital subtract angiography X-ray computed tomography |
| 基金项目:同济大学医科发展基金资助(项目编号 1500219005) |
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| 中文摘要: |
| 目的 观察经球囊导管阻断肝动脉高热灌注生理盐水行肝段热凝固的CT表现,并与病理进行对照。材料与方法 实验猪6头,选用球囊导管阻断肝段动脉血流进行热灌注,导管流出温度设置50～60℃之间。热灌注结束后即刻、14d,行肝脏螺旋CT扫描,14d将实验猪全部处死,取出肝脏进行病理检查。 结果 热灌注后14d,6头实验猪均存活。肝脏热灌注区CT影像学表现：热灌注结束后即刻,热灌注区显示大片状低密度改变,无明显强化,边缘显示模糊；热灌注后14d,CT平扫,肝脏热灌注区呈典型契形低密度改变；CT增强,热灌注区显示 “三环征”,由内向外分为低密度无增强区、边缘强化带和移行区透明带。病理上取得6个热凝固灶,CT上低密度无增强区、边缘强化带和移行区透明带分别代表病理的凝固性坏死区、炎性充血带和纤维化带。结论 增强CT能准确反映经动脉导管肝段介入性热毁损的病理改变,DSA价值有限。 |
| 英文摘要: |
| Objective: To explore image appearance of hepatic segmental ablation by trans-ballooncatheter hyperthermic infusing saline. Methods: The hepatic segmental arteries were occluded by ballooncatheter in six experimental pigs, then infused 780ml saline warmed to 50℃, 55℃, 60℃, flow rate 1-2ml per second for lasting 10min. All pigs were performed digital subtract angiography (DSA) and X-ray computed tomography (CT) exam before and shortly after and 14 days after hyperthermic infusion. Total 6 pigs were sacrificed and the livers were fetched to observe pathologically 14 days after hyperthermic infusion. Results: Six experimental pigs were alive 14 days after hyperthermic infusion. The image appearance of hepatic segmental ablation was as follow: (1) DSA appearance of hepatic artery: the targeting small arteries were destroyed and disappeared and the segmental hepatic arteries were like deadwoods shortly after hyperthermic infusion. Filling defect was seen in hyperthermic areas of the liver and segmental arteries in hyperthermic areas were occluded 14 days after hyperthermic infusion. (2) CT appearance: not enhanced hypointensity lesions were found in the hyperthermic areas shortly after hyperthermic infusion, which brim was blurred. The hypointensity lesion showed “three ring sign” from inner to outer: not enhanced area, rim enhanced strip, dizzy strip after contrast agent enhancing, which representing histopathologically yellow cheese necrosis, inflammation congestion strip, and fibrosis strip from, respectively. Conclusion: Contrast CT can precisely reflect histopathologic changes of hepatic ablation by trans-ballooncatheter intraarterial hyperthermic infusion, while image value of DSA is limited. |
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