16排螺旋CT血管造影在主动脉夹层中的应用

Application of 16-slice spiral CT angiography in aortic dissection

目的探讨16排螺旋CT血管造影在主动脉夹层病变显示中的应用。方法20例主动脉夹层患者(4例为腔内支架隔绝术后)进行16排螺旋CT血管造影检查,采用多层面重建、曲面重建、最大密度投影、容积重建及内窥视镜方式进行血管重建和观察。所有病例均有血管造影对照。结果原始横轴位图像对病变信息的存储最为可靠;多层面重建、曲面重建、最大密度投影、容积重建及内窥视镜在显示血管解剖结构及病变的空间关系上具有优势;不同的重建方式所得图像有不同的显示特点;采用不同的重建方式或多种方式相结合,可全面、立体地显示主动脉夹层病变的范围、真假腔、内膜片、内膜破口、分支血管受累情况和假腔内血栓,并可对介入治疗后血管内支架及周围情况进行观察。结论16排螺旋CT血管造影可以全面显示主动脉夹层的病变和解剖细节,在病变的诊断、术式选择及术后随访中有重要应用价值。

Objective To explore the value of 16-slice spiral CT angiography in the diagnosis of aortic dissection （AD）. Methods Twenty patients with AD underwent 16-slice spiral CT angiography with multi-planar reformation （MPR）, curved planar reformation （CPR）, maximum intensity projection （MIP）, volume rendering （VR） and CT virtual endoscopy （CTVE）. All the original and reconstructed images were studied. Results The original transverse axial images most reliably preserved the fundamental information. The reconstructed images gave better performance in displaying the spatial relation between the blood vessels and the lesions. Images obtained by different reconstruction methods had different characteristics, and combining different display modes allowed clear representation of the features of aortic dissection such as the extension of the lesion, true and false cavity, disrepair of the intimal flap, aortal branch involvement, thrombi and outcome ofendoluminal stenting. Conclusion Multislice spiral CT angiography can fully display the details of aortic dissection and is therefore of important value for the diagnosis and preoperative and postoperative evaluations.