大视野对比常规视野锥形束CT在经动脉化疗栓塞术中的应用

周馨; 石钦; 周永杰; 杜楠; 施惠斌; 梁吉廷; 颜志平; 马婧嵚

doi:10.12025/j.issn.1008-6358.2022.20220388

大视野对比常规视野锥形束CT在经动脉化疗栓塞术中的应用

Application of cone-beam CT in transarterial chemoembolization with large versus conventional field-of-view

摘要

摘要:
目的比较数字减影血管造影（digital substraction angiography, DSA）大视野（field-of-view, FOV）锥形束计算机断层扫描(cone-beam computed tomography, CBCT)与常规FOV CBCT在经动脉化疗栓塞术（transarterial chemoembolization, TACE）中的应用价值。
方法选择2021年10月至12月接受TACE治疗的肝癌患者37例，随机分为大视野组（n=20）和对照组（n=17）。大视野组在术中行大FOV CBCT扫描；对照组行常规CBCT扫描。对两组患者的影像学资料、透视和曝光时间及辐射剂量进行分析，比较两组图像质量和辐射剂量。
结果大视野组3D图像质量达优率为90%，高于对照组的58.82%（P=0.028）。大视野组与对照组平均曝光次数、平均累计透视时间、平均累计曝光时间和空气比释动能差异均无统计学意义。大视野组单位时间剂量面积乘积（dose area product，DAP）低于对照组（26.852±6.430）μGymm²/s vs（53.127±29.087）μGymm²/s，P=0.002。
结论大FOV CBCT技术在TACE术中的3D图像质量优于常规视野CBCT，同时单位时间内DAP低于常规视野CBCT，表明更安全、有效，为肿瘤精准治疗的更好选择。

Abstract:
Objective To compare the application values of digital substraction angiography (DSA) large field-of-view (FOV) cone-beam computed tomography (CBCT) and conventional FOV CBCT in transarterial chemoembolization (TACE).
Methods 37 patients with liver cancer who received TACE treatment from October to December in 2021 were selected and randomly divided into experimental group and control group. 20 patients in experimental group received large FOV CBCT scan during operation, and 17 patients in control group received conventional FOV CBCT scan. The imaging data, fluoroscopy and radiographic time, radiation dose were compared between the two groups.
Results The excellent rate of 3D image quality in experimental group was 90%, which was higher than 58.82% in control group (P=0.030). There were no significant differences in average radiographic times, average cumulative fluoroscopic time, average cumulative radiographic time, and air specific release kinetic energy between the experimental group and the control group. Dose area product (DAP) per unit time in experimental group was significantly lower than that in control group (26.852±6.430 μGymm²/s vs 53.132±29.087 μGymm²/s, P=0.002).
Conclusions Large FOV CBCT has better 3D image quality and lower DAP per unit time than conventional CBCT in TACE surgery, which can be safely and effectively applied in TACE surgery and provide a better choice for precise tumor treatment.

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