主动脉病变16排CT成像技术及其影像学表现特征

Imaging Technique and Features of the 16-slice Detector Spiral CT for Aortic Lesions

通过对21例临床诊断主动脉瘤及主动脉夹层的患者进行西门子16排螺旋CT机(Siemens Somatom Sensation 16)平扫及增强扫描,并同时进行三维重建,以探讨主动脉病变的16排CT成像技术及其影像学表现特征。结果表明:(1)11例主动脉夹层中显示真假腔11例(100%)、内膜片11例(100%)、内膜破口9例(81.8%)、假腔内血栓形成5例(45.5%);(2)壁内血肿1例平扫表现为主动脉壁新月形增厚,密度增高,无内膜撕裂,增扫无强化,为新月形相对较低密度;(3)真性动脉瘤7例均显示动脉瘤大小、范围、腔内附壁血栓及钙化;(4)2例假性动脉瘤均显示动脉旁混杂密度肿块,增扫肿块不均匀强化,强化团与动脉有颈相连。所以16排螺旋CT轴位及3D重建图像,能全面显示主动脉病变的病理解剖改变,为临床治疗提供精细的影像学信息。

The purpose of this study was to describe the 16-slice detector spiral computer tomography （SCT） technique and imaging features of aortic aneurysms. We analyzed 21 patients documented aortic aneurysms, that underwent unenhanced and contrast-enhanced spiral CT with a 16-slice scanner （Sensation 16）, and threedimensional reconstructions were performed for CT scan images. The results showed that： （1） Aortic dissection （11 cases）, included the true and false lumen （11 cases, 100%）, intimal flaps （11 cases, 100%）, intimal tear （9 cases, 81. 8%） and thrombosed false lumen （5 cases, 45. 5%）; （2） Intramural hematoma, unenhanced CT depicted crescent-shaped areas with high attenuation extending along the walls of the aorta, no definable intimal flap, while contrast-enhanced CT showed no enhancement of attenuation in the crescent-shaped areas; （3） True aortic aneurysms （7 cases）, CT revealed the size, range, thrombosis and calcification of all aneurysms; （4） Pseudoaneurysms （2 cases）, the enhanced part of the inhomogeneous masses beside the aorta connected with the aorta shown on contrast-enhanced CT. Therefore, 16-slice detector SCT axial and three-dimensional images can exactly reveal the pathological and anatomical features of aortic aneurysms, and provide detailed imaging information for clinical therapy.