利用64列電腦斷層評估肝動脈灌注化療影像之技術

Technique of Evaluating Hepatic Arterial Infusion Chemotherapy Images Using 64 MDCT

陳碧真(Bi-Zhen Chen) ； 劉雅萍(Ya-Ping Liu) ； 陳啟仁(Chi-Jen Chen) ； 賴世育(Shih-Yu Lai) ； 王永成(Yung-Cheng Wang) ； 侯貴圓(Kuei-Yuan Hou)

《中華放射線技術學雜誌》 34卷4期 (2010/12) Pp. 234-239

https://doi.org/10.30045/CJRT.201012.0003

摘要

利用64列偵檢器電腦斷層掃描儀，掃描含碘顯影劑經由肝動脈灌注化療導管灌注肝動脈的影像，評估導管是否移位及灌注情形。自2008年4月至2009年1月共收集8例肝動脈灌注化療治療後之患者，採用Philips Brilliance 64列偵檢器電腦斷層掃描儀，第一段進行上腹部常規不顯影掃描，第二段進行肝臟灌注攝影，在開始注射含碘顯影劑後10秒及20秒對肝臟進行掃描，第三段進行肝動脈相及門靜脈相常規顯影掃描。結果　可清楚顯示導管之位置及藥物灌注整個肝臟的情形，另外經由3D重組處理最大密度投影冠狀切面影像和容積重建的影像，可以觀察到導管及導管側孔含碘顯影劑出口方向，並以治療前（放置導管前）與治療後追蹤之64列電腦斷層影像比較，可顯現腫瘤分布及大小改變。肝動脈灌注化療在設置導管後，相隔數週或數月實施的化療灌注治療，需要清楚地追蹤導管位置及腫瘤消除或增生狀況，才可安全投以化療藥物，以及決定是否使用其他方法繼續治療，而64列偵檢器電腦斷層掃描儀可清楚顯示導管是否移位，及導管的灌注情形，對患者療程提供更進一步的觀察與評估。

關鍵字

64列電腦斷層 ； 肝動脈 ； 肝動脈灌注化療

並列摘要

64-detector computed tomography was used to detect the patency of the PU catheter for hepatic artery infusion chemotherapy (HAIC) and confirm the location of the PU catheter, as well as assess the hepatic artery perfusion. Between April 2008 and January 2009, eight patients with liver cancer underwent placement of implantable port-catheter system for HAIC and were followed arteriographically with Philips Brilliance 64-detector computed tomography. All patients routinely received nonenhanced CT of the liver. Than the early and late arterial phase started in 10 seconds and 20 seconds after contrast material was infused via the port. Finally the routine hepatic arterial and portal venous phase had be taken after the contrast injection through the antecubital vein. 64-detector computed tomography displayed clearly the location of the PU catheter and the hepatic artery perfusion. The image of maximum intensity projection (MIP) and volume rendering (VR) showed out the direction of the contrast jetted out through the end-hold and side-holds of the PU catheter. Compare the images obtained before and after treatment can show the change of the tumor distribution and size. Hepatic artery infusion chemotherapy started in few weeks or months after the placement of implantable port-catheter system. The safety and the selection of next treatment lean on the confirmed location of PU catheter and the following change of the liver tumors. 64-detector computed tomography can be effectively used to detect the location and infusion of PU catheter. It provides important information about the effect of chemotherapy and further treatment planning.

並列關鍵字

64-detector computed tomography ； hepatic artery ； hepatic artery infusion chemotherapy