多层螺旋CT血管造影在腹主动脉瘤诊断中的价值

Value of Multiple Spiral CT Angiography in Diagnosing Abdominal Aortic Aneurysm

目的:评价多层螺旋CT血管造影在腹主动脉瘤诊断中的价值。材料和方法:24例腹主动脉瘤病人行多层螺旋CT血管造影,其中17例经DSA证实,7例经手术证实,采用容积再现(VR)、最大密度投影(MIP)、表面遮盖显示(SSD)和曲面重建(CPR)对原始数据进行重建。结果:所有行CT血管造影的病人,都能清晰显示瘤体,与周围血管的关系和附壁血栓,能准确测量动脉瘤的相应数据,其中Ⅰ型5例(20.8%),ⅡA型7例(29.2%),ⅡB型2例(8.3%),ⅡC型5例(20.8%),Ⅲ型5例(20.8%)。7例腹主动脉支架置入术后复查能清晰显示支架的位置、范围和管腔通畅情况,4例手术后复查均清晰显示桥血管。结论:多层螺旋CT血管造影是一种无创、快速的检查方法,作为腹主动脉瘤的诊断已可取代DSA。

Purpose： The aim of this study is to evaluate the value of multiple spiral CT angiography in the diagnosis of abdominal aortic aneurysm. Materials and Methods： 24 subjects with abdominal aortic aneurysm, confirmed by DSA in 17 cases and by operation in 7 cases, were continuously performed with multiple spiral CT angiography prior to managements. 11 out of 24 cases were reexamined after the treatments （7 and 4 ） . All the original data for each subject were post- processed with VR, MIP, SSD and CPR. Results： Multiple spiral CT angiography displayed that abdominal aortic aneurysm and its relationship with surrounding vessels and its mural thrombus in all of 24 cases. The size of the abdominal aortic aneurismal body and corresponding data for the lesions were correctly measured. Based on the Schumacher classifications, 24 abdominal aortic aneurysms included type I in 5 cases （20.8%）, type IIA in 7 cases（29.2%）, type IIB in 2 cases （8.3%）, type IIC in 5 cases （20.8%）, and type III in 5 cases （20.8%） . The position and structure of stent and vessel bridge could be distinctly described on CT angiography images. Conclusion： It is believed that multiple spiral CT angiography had a potential ability to replace DSA in diagnosing abdominal aortic aneurysm.