多层螺旋CT在脊髓血管介入术前评估中的价值分析

摘要

Objective:To investigate the value of 64-slice spiral computed tomography (64SCT) in preoperative evaluation of spinal vascular intervention.Methods: Seventeen patients with spinal vascular malformations(SVM) scheduled for spinal vascular interventional therapy in our hospital between January 2012-December 2014 were collected, all received 64-detector spiral CT angiography (64-MDCTA) before surgery, image postprocessing technologies such as volume rendering (VR), maximum intensity projection(MIP) and multiplanar reconstruction(MPR) were applied to conduct three-dimensional reconstruction, the traveling case of spinal cord feeding artery was analyzed and were compared with DSA test results.Results: All of the 17 patients clearly showed the abnormality of spinal cord blood vessels and lesions scope, the SVM classification and lesions scope were exactly the same as that of DSA and intraoperative performance, the coincidence rate was 100%;1 case of patient was not shown fistula, the rest of the patients clearly shown the draining veins around the spinal cord, open position and flow tendency of radiculomedullary artery, the coincidence rates were 100.00%, 94.12%%, 100.00%.Conclusion: 64-MDCTA is important for SVM patients to preoperative evaluation of spinal vascular intervention, for it can fully and accurately reflect the open position and flow tendency of radiculomedullary artery, spatial relationship with the surrounding vessels, spinal cord and vertebral situation, should be widely applied.%目的：研究多层螺旋CT(MSCT)对于脊髓血管介入术前评估的应用价值。方法：选取17例拟行脊髓血管介入术治疗的脊髓血管畸形患者，术前进行64层螺旋CT血管造影(64-MSCTA)，分别采用容积显示(VR)、最大密度投影(MIP)以及多平面重建(MPR)等技术进行三维重建处理，观察脊髓供血动脉的走行情况，并与数字减影血管造影技术(DSA)检查结果进行比较。结果：17例64-MDCTA均准确显示脊髓血管畸形(SVM)异常脊髓血管与病变累及范围，SVM分型与病变部位均与DSA及术中所见完全一致，符合率为100%；1例患者未见瘘口，其余患者均清晰地显示了脊髓周围引流静脉、供血动脉瘘口及走行，且与DSA一致，符合率依次为100.00%、94.12%及100.00%。结论：64-MSCTA能够全面、准确地反映SVM患者脊髓供血动脉开口、走行、周围血管关系、脊髓组织以及椎体情况，对于脊髓血管术前评估具有重要意义，值得推广应用。