Cone-Beam CT Hepatic Arteriography in Chemoembolization for Hepatocellular Carcinoma: Angiographic Image Quality and Its Determining Factors
Cone-Beam CT Hepatic Arteriography in Chemoembolization for Hepatocellular Carcinoma: Angiographic Image Quality and Its Determining Factors
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DOI：
10.1016/j.jvir.2014.04.011
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发表时间：
2014-09-01
影响因子：
2.9
通讯作者：
Park, Jae Hyung
中科院分区：
文献类型：
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作者：
Lee, In Joon;Chung, Jin Wook;Park, Jae Hyung
目的：分析锥形束CT肝动脉造影在肝细胞癌（HCC）化疗栓塞中的图像质量及其影响因素。材料与方法：自2009年9月至2010年12月，连续399例HCC化疗栓塞患者行锥形束CT扫描。有12例（3%）患者因屏气困难而被排除。在387例接受锥形束CT肝动脉造影的患者中，根据纳入标准，最终有100例患者被纳入研究。对肝动脉各节段的最大强度投影图像质量进行评分。图像质量的潜在决定因素是膈运动、门静脉增强和肝动脉与实质增强比。同时评估造影剂流速、x线延迟及导管尖端位置。结果：锥形束CT肝动脉造影显示700个肝段中至少有625个（89.3%）可显示肝动脉亚段。膈肌运动、门静脉增强明显、肝动脉与实质增强比低使图像质量恶化（P < 0.001, P = 0.022, P = 0.017）。由于心脏运动伪影，左外侧节段（S2和S3）的图像质量较其余肝节段（S4-S8）差。结论：在大多数情况下，锥豆CT肝动脉造影图像的质量足以至少显示肝段下动脉。呼吸和心脏运动、门静脉增强、肝动脉与实质增强比显著影响锥束CT肝动脉成像质量。
Purpose: To analyze image quality and the factors that determine it for cone-beam computed tomography (CT) hepatic arteriography in chemoembolization for hepatocellular carcinoma (HCC).Materials and Methods: From September 2009 December 2010, 399 consecutive patients referred for chemoembolization of HCC were scheduled for cone-beam CT scan. There were 12 patients (3%) excluded because of difficulty with breath-hold. Of the 387 patients who underwent cone-beam CT hepatic arteriography, 100 patients were ultimately included in the study according to inclusion criteria. Maximum intensity projection images were scored for image quality of each segmental hepatic artery. Potential determining factors for image quality were diaphragmatic motion, portal vein enhancement, and hepatic artery-to-parenchyma enhancement ratio. The flow rate of Contrast media, x-ray delay, and location of the catheter tip were also evaluated.Results: It was possible to trade at least subsegmental hepatic arteries in 625 of 700 segments (89.3%) on cone-beam CT hepatic arteriography. Diaphragmatic motion, prominent portal vein enhancement, and low hepatic artery-to-parenchyma enhancement ratio worsened image quality (P < .001, P = .022, and P = .017). Owing to cardiac motion artifacts, image quality of the left lateral segments (S2 and S3) was poorer compared with the remaining hepatic segments (S4-S8).Conclusions: In most cases, the quality of cone-bean CT hepatic arteriography images was good enough to trace subsegmental hepatic arteries at a minimum. Respiratory and cardiac motion, portal vein enhancement, and hepatic artery-to-parenchyma enhancement ratio significantly affected the image quality of cone-beam CT hepatic arteriography.