肝癌の肝動脈造影CTの問題点,特に動脈の破格と層流の影響の検討

肝癌肝动脉造影CT的问题，特别是考虑动脉不规则和层流的影响

• 批准号: 08770703
• 负责人: 渡邉 順久
• 金额: $ 0.45万
• 依托单位: Yamagata University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Young Scientists (A)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-08770703/
• 关键词: liver; CT; angiography; CT during arteriography; liver neoplasm; normal variation

目的:バルーンカテーテルを用い,血流改変を行うことで肝のCTAの非腫瘍部の造影の均一性が得られるか検討すること.対象及び方法:1994年3月から1996年10月に,血管撮影と同日に肝動脈造影CT(CTA),経動脈性門脈造影CT(CTAP)を行った92症例(96回)のCTAの内,未治療でかつ肝全体がCTAの対象になった65症例(67回)のCTA.通常の造影(投げ込み法)33症例,バルーンカテーテルを用い肝への血流が胃十二指腸動脈から逆流だけになるように血流を改変して造影した(バルーン法)34症例.均一度を,I:均一〜ほぼ均一,II:やや不均一,III:不均一,の3段階に分けて評価.造影欠損の有無は別項目として検討.結果:投げ込み法は,Iが18例(55%),IIが11例(33%),IIIが4例(12%)であった.造影の不均一の原因はカテーテルの位置不良であった.造影欠損は1例(3%)であった.造影欠損の原因はカテーテル位置不良であった.バルーンカテーテル法は,Iが25例(73%),IIが5例(15%),IIIが4例(12%)であった.造影の不均一の原因が推測できた3例は,血流改変により右胃動脈固有肝動脈起始などに逆流を生じたためと考えられた.造影欠損は6例(18%)であった.造影欠損の内容は,尾状葉枝の分岐の破格による尾状葉の造影欠損が4例,血流改変に伴う動脈圧の低下に伴い,下横隔動脈から血流が生じたと推測される横隔膜直下の造影欠損が2例であった.結論:通常のカテーテルを用いたCTAでは,カテーテルの位置不良が原因の造影不良が起こりやすい.バルーンカテーテルを用い血流改変を行うと,非腫瘍部の造影は均一になる傾向にはあるが,血流改変により,造影不良や造影欠損を生じてしまう場合がある.

Objective: To investigate the homogeneity of liver CTA imaging in non-tumorous areas. Subjects and methods: From March 1994 to October 1996, vascular angiography, CT angiography of liver (CTA) and CT angiography of cerebral arterioportal vein (CTAP) were performed on the same day in 92 cases (96 rounds). Without treatment, CTA was performed in 65 cases (67 rounds) for all liver CTA subjects. There were 33 cases for ordinary angiography (projection method), and 34 cases for angiography (Bākantete method) when the blood flow in the gastroduodenal artery was reversed due to the backflow of blood from the liver. Uniformity,I: Uniformity ~ Uniformity,II: Uniformity,III: Uniformity, and 3-stage evaluation. Contrast defect and whether there is any other item or not. Results: There were 18 cases (55%) in I group, 11 cases (33%) in II group and 4 cases (12%) in III group. The reason for the non-uniformity of the contrast medium is that the position of the contrast medium is not good. 1 case (3%) of imaging defect. The cause of the imaging defect is poor positioning. In the method of classification, 25 cases (73%) in I group, 5 cases (15%) in II group and 4 cases (12%) in III group. The cause of the non-uniformity of the contrast medium was speculated in 3 cases, and the blood flow was changed in the right gastric artery. 6 cases (18%) of imaging defect. 4 cases of contrast defect of caudate lobe, 2 cases of contrast defect of inferior septal artery, 4 cases of contrast defect of caudate lobe, 2 cases of contrast defect of inferior septal artery. Conclusion: CTA is usually used in the case of bad location of the case. The blood flow in the non-tumorous part of the body is changed, and the contrast medium is changed.