Cone Beam CT Technology In The Application Of Interventional Diagnosis And Treatment Of Liver Cancer

Objective: Explore the application of cone beam CT technology on interventional diagnosis and treatment of liver neoplasmsMethods:1 From January 2014 to December 2014, selected from 627 cases with liver perfusion chemotherapy embolism, including 442 cases of primary liver cancer, 185 cases of metastatic liver cancer, including application of cone beam CT scans of 97 cases, observed lesions of 9 cases, observe the blood supply artery of 17 cases, 41 cases had observed therapeutic effect. 2 statistical methods Kendall s’ W test evaluation in additional information to evaluate the consistency of the observer, Kendall ’s W coefficient shows good consistency between 0.5 to 0.8, higher than 0.8 showed very good consistency. 3 case group: 3.1 Selection of conventional DSA angiography showed lesions is not obvious or found additional lesions(spiral CT undiscovered lesions) of the patients, cone beam CT enhanced scan, comparing the two found lesions 3.2 Selection of conventional DSA imaging, it found that blood vessels contorts circuity patients or overlap, cone beam CT enhanced scan, observe the tumor blood supply artery contorts, guidance intubation. 3.3 Lack of blood flow to the patient after embolization, the common DSA imaging showed poor therapeutic effect, line of cone beam CT scan to observe whether lesions embolism completely 4 cone beam CT usage By the director of the physician to decide whether to patients with cone beam CT examination. Told the whole process of cone beam CT examination, and the patient breathing training, charged body keep motionless and breathless. Contrast agent will be diluted to 40% ~ 40%, and total imaging using contrast agents for 10 ~ 50 ml, flow rate of 1 ~ 4 ml/s, high pressure syringe give pressure to 100 ~ 700 psi, exposure to 8 seconds delay for 2 seconds. Watch lesions cone beam CT scan: use Dyna CT 8 SDR mode enhanced scanning, when the conductor head in celiac artery, use of contrast medium total 40 ~ 50 ml, flow rate of 4 ml/s, high pressure syringe to give pressure to 300 psi, the injection delay for 5 ~ 8 s; When the head is located in the proper hepatic artery, the use of contrast medium total 20 ~ 30 ml, velocity of 1.5 ~ 2.5 ml/s, high pressure syringe to give pressure to 200 psi, the injection delay for 5 ~ 8 s; When the conductor head is in the left or of the right liver, liver further than choosing an artery intubation, use of contrast medium total 10 to 20 ml, velocity is 1 ~ 2 ml/s, high pressure syringe to give pressure to 100 psi, the injection delay for 5 ~ 8 s. To observe the blood supply artery cone beam CT scan: use Dyna CT 8 SDR mode enhanced scanning, when the conductor head in celiac artery, use of contrast medium total 40 ml ~ 50 ml, flow rate of 4 ml/s, high pressure syringe to give pressure to 300 psi, the injection delay for 1 ~ 3 s; When the head is located in the proper hepatic artery, the use of contrast medium total 20 ~ 30 ml, velocity of 1.5 ~ 2.5 ml/s, high pressure syringe to give pressure to 200 psi, the injection delay for 1 ~ 3 s; When the conductor head is in the left or of the right liver, liver further than choosing an artery intubation, use of contrast medium total 10 to 20 ml, velocity is 1 ~ 2 ml/s, high pressure syringe to give pressure to 100 psi, the injection delay for 1 ~ 3 s. Observed therapeutic effect cone beam CT scan: use scan. Statistical methods: compare the spiral CT and cone beam CT at the number of lesions(t test)Results: 1 In 627 cases with conventional surgery by cone beam CT scan, 97 cases(15%); Three perfusion chemotherapy in 13 patients had a regular cone beam CT scans(about 23%), there are 18 cases in 42 cases with embolization using cone beam CT scans(about 43%), in 572 of 572 cases of perfusion chemotherapy embolization using cone beam CT scan(13%). 2 In all 97 cases times line of cone beam CT scans, 29 patients of cone beam CT scan did not provide additional information(30%), 37 cases of patients of cone beam CT scan provides additional information(38%), 31 patients of cone beam CT scan provides effective additional information(32%). Kendall s W test evaluation ’cone beam CT in liver cancer surgery with conventional additional information provided by the application of evaluation of consistency, Kendall’ s W coefficient is higher than 0.8, showing very good consistency. 3 The blood vessels, vessels- nature and essence of information: Observed lesions, 9 times, preoperative plain spiral CT found 11 lesions, intraoperative cone beam CT found 37 lesions. To observe the blood supply artery of 17 cases, are common DSA failed to clearly show the tumor blood vessels, cone beam CT reconstruction images can clear display contorts the vessels. Observe therapeutic effect of 41 cases, including common DSA imaging showed different from the actual effect of embolization for 8 cases.Conclusions: Through this study can be found in the liver cancer surgery with conventional, Dyna CT is an important auxiliary tool. Under the condition of without increasing the contrast agent, using Dyna CT check can get soft tissue type in the technique with conventional CT image information, clear on the conventional DSA can not display or poor blood vessels, provide clear path for the selective intubation, understand the relationship between tumor blood supply arteries and essence, determine whether the extrahepatic blood supply artery of doubt involved in tumor blood supply, improve the small liver cancer lesions and abnormal lesion detection rate. In addition the embolization can immediately after the embolization effect evaluation and prognosis. All in all, Dyna CT in liver cancer chemotherapy embolism has important clinical value.