杨宁介入医学网

        旋转平板透视的进展（或锥束CT，cone-beam CT），有类CT多平面成像和实时透视的成像的优点【52–54】。这些图像的表现在发现肿瘤方面优于标准血管造影【55】。另外其软件设计功能可用于三维血管造影数据重建，在各个方向上显示肿瘤滋养血管并因此提供经导管治疗的引导【56】。改变了日常临床介入的工作实践

Hybrid Operating Room (Artis ZEEGO)：肿瘤和其它部位介入治疗专门设计

除了提供类CT成像，医生还获得了典型透视下介入操作的空间。已经有X射线透视机功能的血管造影机，在肿瘤介入成像设备中具有更强大的角色【57】。

3D acquisition is routenely used

血管3D成像	类CT成像	医生还获得了典型透视下介入操作的空间

介入手术室内的许多操作需要在全麻下进行

Changes in clinical practice

Devellopement hybrid procedure with GI surgeon and endoscopist (Multidisciplinary team)	Modify Artis Zego table for coelioscopic surgery

Multiplanar reconstruction image with graphic inputs from C-arm cone beam CT system (Artis Zee BA Twin, Siemens Healthcare) shows progression view. We initially define target site (red circle) and skin-entry point (yellow cross) on image. Needle path (green line) is then automatically projected	Software automatically computes necessary C-arm angulation for bull's eye view. The C-arm is brought to this position under physician's input. Radiologist manipulates ablation needle shaft (white arrow) such that both needle tip and hub are superimposed on center of circle representing target site, and needle is inserted straight.
Real-time fluoroscopic images with C-arm are immediately obtained in progression view, and needle is advanced along planned needle path (dotted line) to target site (white circle).	Panel shows contrast-enhanced C-arm cone beam CT image obtained just after radiofrequency ablation in progression view to screen for residual vascularity.

        虽然致密的结构，如骨和血管内造影剂使这些设备系统是足以实现可视化成像，在软组织分辨率和显示范围（FOV）挑战依然存。随着这一相对较新的技术的提高，许多CT引导下介入治疗可能会减少。



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