双源CT血管成像在主动脉病变诊断中的临床应用价值

摘要

目的：评价双源CT(DSCT)在主动脉病变诊断中的临床应用价值。方法：回顾分析57例经DSCT血管成像诊断的各种主动脉病变资料，利用多层面重建(MPR)、最大密度投影(MIP)及容积再现(VRT)技术重组图像，判定主动脉病变情况，并与其他影像学检查对照。结果：双源CT血管成像良好的显示了主动脉瘤、主动脉夹层和主动脉其他病变。14例主动脉夹层，MPR较好地显示夹层和血栓范围以及弓部血管受累情况；表面覆盖显示(SSD)见内膜片螺旋状剥离，可以区分真假腔，20例主动脉瘤，SSD清晰显示动脉瘤的范围和周围血管的关系；MPR显示壁内血栓的范围；MIP则显示了血管壁的钙化和血管内支架的位置及支架周围情况。MPR较好显示了假性动脉瘤与管腔的关系及动脉破口，主动脉壁内血肿4例，大动脉炎3例，主动脉缩窄3例，主动脉粥样硬化7例，正常6例。与其他影像学检查进行对比，结果基本相近。结论：双源CT血管成像是评价主动脉病变较好的影像检查方法，可为临床治疗提供更多的信息。%Objective: To evaluate the clinical applications value of DSCT angiography in the diagnosis of aortic diseases. Methods:In this group, 57 cases with aortic diseases (38 male,19 female) were studied retrospectively. Images were retrospectively reconstructed under different reformations multiplanar reconstruse-tion (MPR), maximum intensity projection(MIP)and volume rendering technology (VRT) and compared with the other radiological technology. Results: DSCT images could clearly show the lesions of aneurysm or aortic dissection and other aortic diseases. MPR successfully clarified the extent of the intimal flap and intraluminal thrombus in 14 patients,it was useful to display the anatomy in the region of arch;SSD showed the spiraling of the intimal flap, and could differentiate the true lumen from the false one.SSD better showed the extent of aneurysm and the relationship between aneurysm and arterial branches in 20 aneurysm or aortic; MPR was useful to determine the extent of intraluminal thrombus while MIP depicted the calcification of aorta, position and anatomic relationship of the stent. Site of rupture of aorta and pseudoaneurysm were shown clearly with MPR. Aortic intramural hematoma in 4 cases, Takayasu's arteritis in 3 cases, Coarctation of aorta in 3 cases, Atherosclerosis of aorta in 7 cases, Normal in 6 cases. Compared with other radiological technology, the result is basically similar. Conclusion:DSCT angiography is a valuable tool in the assessment of aortic diseases and can provide more useful information for the surgeons.