多层螺旋CT腹腔动脉成像的临床应用研究

Multislice spiral CT celiac arteriography and its clinical applications

目的:探讨多层螺旋CT(MSCT)腹腔动脉成像的能力及其临床应用价值。方法:随机选择65例行腹部CT增强扫描的患者,选择5.0mm×2.5mm的扫描参数,行层厚3.0mm间隔1.5mm的轴面重建。采用最大密度投影(MIP)和容积重建(VR)两种后处理成像方法,部分病例增加曲面重建(CPR)。统计MIP和VR二种成像方法对腹腔动脉及其分支的显示率。结果:36例正常腹腔动脉;6例变异腹腔动脉及分支;23例病变腹腔动脉。MIP和VR法血管分支显示率分别为:肝总动脉、肝固有动脉、脾动脉100.0%(65/65),肝右动脉80.0%(52/65),肝左动脉76.9%(50/65),胃左动脉73.9%(48/65),胃十二指肠动脉96.9%(63/65)。结论:MSCT血管成像(MSCTA)显示腹腔动脉及其分支在腹部病变的诊断、鉴别诊断和判断肿瘤的可切除性方面有较高的临床应用价值。MIP和VR法的显示能力相当,但VR比MIP重建的血管图像更优。

Objective:To disccuss the ability of displaying celiac artery and its branches with multislice spiral computed tomographic angiography(MSCTA) and to assess its clinical applications. Methods:Sixty-five patients recommended to abdominal enhanced CT were randomly selected in this investigation. Images were obtained with 5.0 mm × 2.5 mm scan project, the raw data was reconstructed with 3.0 mm thick section and 1.5 mm interval. All data of the arterial phase were reconstructed in the mode of maximum intensity projection(MIP) and volume rendering(VR), curved planar reformation(CPR) was added in part cases. The displaying rate of celiac artery and its branches with MIP and VR was calculated, respectively. Results:Thirty-six cases were common celiac arteriography; 6 cases were variant celiac arteriography; 22 cases were pathological celiac arteriography. The displaying rate of common hepatic artery, proper hepatic artery and its right and left branches,splenic artery,left gastric artery and superior gastroduodenal artery with VR and MIP was 100.0%(65/65),100.0%(65/65),80.0%(52/65),76.9%(50/65),100.0%(65/65),73.9%(48/65),96.9%(63/65),respectively. Conclusion:MSCTA is a better non-invasive technique of displaying celial artery and its branches and could provide more information for clinic in diagnosis and differential diagnosis of abdominal lesions and judgement of tumor resectability. The abilities of MIP and VR to show celiac artery and its branches are equivalent, but VR is superior to MIP in image quality.