64层螺旋CT头部血管减影成像技术初探

Preliminary Investigation of 64-slice Helical Computed Tomography Subtraction Angiography of Head

【目的】探讨64层螺旋CT血管减影造影技术显示头部血管的能力及优势。【方法】20例头痛患者进行头部64层CT血管减影造影检查。平扫后,静脉团注对比剂进行CT血管造影,将增强前后图像重建成薄层后进行减影,从减影图像中提取动脉,进行血管三维显示。【结果】20例减影均能显示颈内动脉、椎动脉及其主要分支,其中12例无颈椎及颅底骨质干扰,血管全貌显示,余8例因头部轻微运动,颅底及颈椎骨质未能完全减去,但动脉亦能完整显示,不影响诊断。【结论】64层CT血管减影造影,重建需时少,能提供类似MRA和DSA的血管图像,值得在临床中推广应用。

[Objective] To investigate the role and advantages of 64-slice helical computed tomography subtraction angiography in displaying the cranial arteries. [Methods] Cranial subtraction angiography were performed in 20 patients with headache using a 64-slice helical computed tomography, After the plain scan, the contrasted scan was obtained with bolus injection of contrast media through venous. After reconstructed into thin slice images, the images of plain and contrasted scan were subtracted, The cranial arteries was extracted and observed with the techniques of volume rendering （VR） and maximum intensity projection （MIP） using the software In Space from the serious subtracted images. [Results] The cranial arteries and their main branches could be displayed in all 20 patients. In 12 of them, the full extent of internal carotid and vertebral arteries was clearly displayed without bony contamination from cervical vertebrae and skull base. In other 8 patients, the arteries was clearly displayed but the skull base and cervical vertebrae could not completely removed due to slightly motion of head, but without precluding a correct diagnosis. [Conclusion] 64-slice helical computed tomography subtraction angiography, with its less time consumption of reconstruction, and high resolution vessel image, could clearly display cranial and cervical arties similar to the MRA and DSA, and is worthy to be widely applied in clinical settings.