多层螺旋CT血管成像的临床应用

Multi- slice spiral CT angiography: clinical application and the evaluation

目的探讨多层螺旋CT血管成像(MSCTA)在全身各部位血管及血管相关病变的临床应用价值。方法对73例CT血管成像(CTA)的影像学资料进行回顾性分析,颅脑血管CTA27例,颈部动脉CTA8例,肺动脉CTA10例,冠状动脉CTA6例,主动脉CTA11例,下肢动脉CTA11例。采集的原始数据经主机上的重叠层厚基础重建后装载到后处理工作站,使用三维软件的最大密度投影(MIP),表面遮盖重建(SSD)及容积漫游技术(VRT)等功能软件进行重建及评价。结果73例中有71例检查部位的血管显示良好符合诊断要求,共发现血管异常63例,其中脑动脉瘤7例,脑动静脉畸形5例,颈内动脉海绵窦瘘2例,脑血管闭塞2例,脑胶质瘤2例,脑膜瘤3例,颈动脉狭窄4例,椎动脉狭窄2例,锁骨下动脉支架放置术后1例,肺动脉栓塞3例,肺癌侵及肺动脉5例,冠状动脉狭窄3例,主动脉夹层4例,主动脉明显钙化狭窄5例,主动脉瘤2例,肝癌2例,肾动脉狭窄2例,Budd-Chiari综合症2例,髂外动脉闭塞2例,股动脉狭窄5例。结论结合CT轴位图像及各种重建成像,MSCTA能显示全身各部位血管及血管相关病变的范围及与周围组织的关系,是一种安全、简便、可靠、无创伤的检查方法。

Objective To evaluate the clinical application of multi - slice spiral CT angiography （MSCTA） in diagnosis of vascular diseases. Methods Imaging materials of multi- slice spiral CT angiography of 73 cases were retrospectively analyzed, including 27 cases of intracranial vascular CTA, 8 of carotid CTA, 10 of pulmonary artery CTA, 6 of coronary artery CTA, 11 of aortic CTA, and 11 of low extremity artery CTA. After the raw data was reconstructed by overlapping slice - thickness, the axial images were uploaded to workstation for post data processing, and were then evaluated and reconstructed using 3D software including maximum intensity projection （MIP）, shaded surface display （SSD）, and volume rendering technique （VRT）. Results The blood vessels were successfully demonstrated in 71 cases out of 73. Abnormality was found in 63 cases out of 71. The intracranial CTA showed aneurysm in 7 cases, arteriovenous malformation in 5, carotid - cavernous fistula in 2, cerebral vascular occlusion in 2, astrocytoma in 2, and meningioma in 3. The carotid CTA revealed carotid stenosis in 4 cases, vertebral artery stenosis in 2 and a post - bracket implantation subclavian artery. In pulmonary artery CTA, pulmonary artery embolism and 5 cases of pulmonary artery involved with lung cancer were seen in 3 cases. In coronary artery CTA, coronary artery stenosis were shown in 3 cases. The aortic CTA demonstrated aortic dissection in 4, aortic stenosis calcification in 5, aortic aneurysm in 2, liver cancer in 2, renal artery stenosis in 2, and Budd -Chiari syndrome in 2. CTA of low extremity artery reavealed external iliac artery occlusion in 2 and femoral artery stenosis in 5. Conclusion By combining axial images with various reconstructed images, blood vessels all around the body can be highlighted, so that the scope of vascular diseases and their relations with adjacent organs can also be evaluated. MSCTA is of convenience, reliability, safety and noninvasive.