摘要
目的探讨MR检查结合三维锥束CT(3D-CBCT)优化子宫动脉栓塞术(UAE)治疗子宫肌瘤流程的作用。方法按照不同治疗程序选取子宫肌瘤20例患者为观察组,对其采用一种新的优化程序,在术前通过3D重建对比增强MR血管造影预测了最佳X线管倾角;通过双相3D-CBCT预测栓塞终点。另选21例回顾性评估子宫肌瘤患者为对照组,采用传统的UAE治疗方式。两组患者在辐射剂量、检查时间和对比剂用量等方面进行了比较。结果在保证血管造影图像质量的前提下,新的优化程序显著降低了平均总剂量-面积乘积(307,900±47,790 vs.652.100±68,580)mGy.cm^(2),P=0.02;平均子宫剂量(87.70±9.36 vs.134.80±10.14)mGy,P=0.002;平均卵巢剂量(101.70±9.12 vs.165.20±11.79)mGy,P=0.04和平均手术时间(45.88±2.64vs.67.30±3.98)min,P<0.01;平均对比剂剂量(75.0 vs.135.0)ml,P<0.001。结论通过引入优化程序,患者辐射剂量和对比剂用量显著降低,同时保持了最佳的成像质量和疗效。
Objective To compare the patients’radiation exposure during uterine artery embolisation(UAE)before and after introduction of MR combined with three-dimensional cone beam CT(3D-CBCT)optimization procedure.Methods The prospective study included 20 consecutive prospective patients for whom a new optimization procedure was introduced and preprocedural prediction of the best tube angle obliquity was predicted by using three-dimensional reconstructed contrast enhanced MR angiography(3D-MRA)and endpoint of embolization was determined by using 3D-CBCT.The radiation dose,fluoroscopy time,and contrast medium volume for those patients were compared with those data in 21 retrospectively assessed control patients from the prior 21 procedures performed by the same interventionist.Results There were no significant differences in demographic characteristics and operative fibroid and uterine volumes in the two groups.The new optimization procedure led to a significant reduction in mean total dose area product(DAP)(307,900±47,790 vs.652.100±68,580)mGy.cm^(2),P=0.02;mean uterine dose(87.70±9.36 vs.134.80±10.14)mGy,P=0.002;mean ovary dose(101.70±9.12 vs.165.20±11.79)mGy,P=0.04,and mean operation time(45.88±2.64vs.67.30±3.98)min,P<0.01;mean contrast agent dosage(75.0 vs.135.0ml,P<0.001),without impairment of the procedure and angiographic image quality.Conclusion A substantial reduction by 38% of DAP values and reduction by 44%in contrast medium volume used respectively are demonstrated with introduction of optimization procedure,while maintaining optimal imaging quality and efficacy.
作者
余苗深
张建
梦存坤
张梦龙
YU Miaoshen;ZHANG Jian;MENG Cunkuen;ZHANG Menglong(Department of Minimally Invasive,The Affiliated Ganzhou Hospital of Nanchang University,Ganzhou People’s Hospital,Ganzhou 341000,China;Department of Pathology,Ganzhou People’s Hospital,Ganzhou 341000,China;Library of Shandong First Medical University(Shandong Academy of Medical Sciences),jinan 250117,China)
出处
《医学影像学杂志》
2024年第11期123-126,共4页
Journal of Medical Imaging
基金
江西省赣州市人民医院博士科研基金项目(编号:Bsqd2020002)。
关键词
子宫动脉栓塞
三维锥束CT
磁共振血管造影
影像学诊断
Uterine artery embolisation
Three-dimensional cone beam CT
Magnetic resonance angiography
Imaging
