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足头向穿刺路径在膈肌下方肝肿瘤消融治疗中的CT模拟测量研究
刘源,李曦,张莉敏,王奇奇,刘洋,王科,钟森,何春水
0
(成都中医药大学临床医学院/附属医院血管外科介入治疗中心;成都中医药大学临床医学院/附属医院消化科;成都中医药大学临床医学院/附属医院感染科)
摘要:
【摘要】 目的 对足头向穿刺路径进行模拟测量并评价在膈肌下方肝肿瘤热消融治疗中的临床应用价值。方法 重建患者上腹部CT图像,选取有代表性的3个矢状面和1个冠状面作为标准层面,在各层面建立膈下标准病灶模型,并采用足头向穿刺路径进行模拟穿刺。测量各平面上膈肌高度、穿刺路径长度及间距。采用可到达性评价模拟穿刺时穿刺针分布于标准病灶中的最理想的位置情况。结果 纳入86例患者行测量研究,多数患者矢状2、3面的膈肌高度低于2cm,仅分别对平面内1511%的病灶e和813%的病灶f进行了测量。标准病灶a、b、c、d、b’的完全到达比例分别为5243%、6097%、3837%、5294%、6353%,中位路径长度分别为1039cm、1337cm(背侧,腹侧1266cm)、1315cm、888cm、1126cm,中位穿刺路径间距分别为21cm、209cm(背侧,214cm腹侧)、206cm、211cm、2145cm。结论 采用足头向穿刺路径进行穿刺,标准病灶a、b、d、b’有较高的完全到达比例,穿刺宽容度较高,有进一步在临床中应用的价值。标准病灶c的完全到达率不高。标准病灶e、f需要采用该路径穿刺的比例不高。
关键词:  足头向穿刺路径  膈肌下方病灶  消融  安全性  可到达性  宽容度  模拟测量
DOI:
基金项目:
The CT simulated measurement study of the foot head direction puncture pathway used in the liver tumors adjacent to diaphragm
LIU Yuan,LI Xi,ZHANG Limin,WANG Qiqi,LIU Yang,WANG Ke,ZHONG Sen,HE Chunshui
(Department of Vascular Surgical and Interventional Radiology, Teaching Hospital of Chengdu University of Traditional Chinese Medicine;Department of Gastroenterology, Teaching hospital of Chengdu University of Traditional Chinese Medicine;Department of Infectious Disease, Teaching Hospital of Chengdu University of Traditional Chinese Medicine)
Abstract:
【Abstract】 Objective To evaluate clinical application value of foothead direction puncture pathway (FHDPP) in thermal ablation treatment against hepatic tumor adjacent to diaphragm.Methods Abdominal CT images were reconstructed and three representative sagittal planes and one coronal plane were selected as standard planes, in which standard lesions model beneath diaphragm were established. Then FHDPP were applied to stimulate the puncture these lesions. Diaphragm height, puncture pathway length and distance were measured in each planes. Accessibility was adopted to evaluate the ideal site of puncture needle within the standard lesion. Results 134 patients were collected, with 86 cases included and 48 cases excluded. Diaphragm heights of sagittal plane 2 and 3 were<2cm in most patients and only 1511% of lesion e and 813% of lesion f located in these two planes were eligible for measurement. The proportion of full access in standard lesion a, b, c, d and b’ were 5243%, 6097%, 3837%, 5294% and 6353%, respectively; the median puncture pathway length were 1039cm,1337cm(dorsal side,ventral side 1266cm), 1315cm, 888cm and 1126cm; the median puncture pathway distance were 21cm, 209cm(dorsal side,214cm ventral side), 206cm, 211cm and 2145cm. Conclusion FHDPP has relatively high proportion of full access and tolerance level for standard lesion a, b, d and b’, which indicates application value in further clinical practice. The full access rate of standard lesion c was not high. The possibility of using FHDPP in lesion e and f is low.
Key words:  Foot head direction puncture pathway  Tumor lesion adjacent to diaphragm  Ablation  Safety  Accessibility  Tolerance  Simulated measurement

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