摘要
目的探讨双源CT血管造影(CT angiography,CTA)对进展期胃癌胃周血管的三维重建能力,评价其对腹腔镜胃癌根治术的指导意义。方法25例拟行腹腔镜胃癌D2根治术患者行腹部双源CT增强扫描,用容积再现技术(volume rendering technique,VRT)进行三维血管重建,根据其CTA表现评价胃周血管的空间解剖特征,将所得的解剖学资料与腹腔镜下血管解剖对比。结果双源CT血管重建准确显示胃左动脉25例,胃右动脉15例,胃左静脉5例,肝动脉、胃十二指肠动脉全部显示,其中肝右动脉起自肠系膜上动脉1例,胃左静脉直接汇入门静脉2例。脾动脉起源相对固定。根据CTA结果指导腹腔镜下进展期胃癌D2根治术,手术均顺利完成,无中转开腹。重建的胃周血管与术中活体解剖完全吻合。结论双源CTA能清晰显示腹腔干及其分支动脉,以及部分静脉血管,对腹腔镜进展期胃癌D2根治术具有重要的指导意义。
Objective To investigate 3-dimension(3D) reconstruction of main perigastric blood vessels by dual-source CT angiography(CTA) in advanced gastric carcinoma,and evaluate its guidance in laparoscopic radical resection for gastric carcinoma.Methods Twenty-five patients undergoing laparoscopic D2 radical gastrectomy in our hospital from January 2010 to September 2011 preoperatively received abdominal dual-source CT with enhance scanning,and 3D reconstruction of main peri-gastric blood vessels was performed with volume rendering technique(VRT).The anatomical characteristics of the main perigastric vessels were evaluated by CTA,and compared with intraoperative vascular anatomy.Results DSCTA displayed the right gastric artery in 15 cases,left gastric vein in 5,and left gastric artery,common and proper hepatic arteries and gastroduodenal artery respectively in all cases.Among these cases,DSCTA revealed vascular variations including the right hepatic artery originating from superior mesenteric artery in 1 case,and left gastric vein into the portal vein in 2 cases.The origin of the splenic artery was regular relatively.With the guidance of vascular reconstruction by CTA,laparoscopic D2 radical gastrectomy were all performed successfully.The characteristics of main perigastric vessels revealed by CTA were in accordance with intraoperative anatomy.Conclusions DSCTA could clearly display main perigastric vessels including celiac axis and its branches,sometimes venous vessels.Reconstruction of main perigastric vessels by DSCTA is of great clinical importance in laparoscopic D2 radical gastrectomy for advanced gastric caner.
出处
《消化肿瘤杂志（电子版）》
2011年第4期237-239,共3页
Journal of Digestive Oncology(Electronic Version)
关键词
双源CT血管造影
腹腔镜
胃癌根治术
Dual-source CT angiography(DSCTA)
Laparoscopy
Radical resection of gastric cancer
