MR联合3D锥束CT优化程序在子宫动脉栓塞术治疗子宫肌瘤中的应用价值
Application of MR combined with 3D cone beam CT optimization procedure in uterine artery embolization for uterine fibroids
余苗深 1张建 2梦存坤 3张梦龙1
作者信息
- 1. 南昌大学附属赣州医院 江西省赣州市人民医院微创介入科 江西 赣州 341000
- 2. 江西省赣州市人民医院病理科 江西 赣州 341000
- 3. 山东第一医科大学(山东省医学科学院)图书馆 山东 济南 250117
- 折叠
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.cm2,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.
Abstract
Objective To compare the patients'radiation exposure during uterine artery embolisation(UAE)before and af-ter introduction of MR combined with three-dimensional cone beam CT(3D-CBCT)optimization procedure.Methods The pro-spective study included 20 consecutive prospective patients for whom a new optimization procedure was introduced and preproce-dural 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 re-duction in mean total dose area product(DAP)(307,900±47,790 vs.652.100±68,580)mGy.cm2,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.135.0)ml,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 op-timization procedure,while maintaining optimal imaging quality and efficacy.
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Key words
Uterine artery embolisation/Three-dimensional cone beam CT/Magnetic resonance angiography/Imaging引用本文复制引用
出版年
2024
NETL
NSTL
万方数据