16层CT在显示腔静脉滤器植入防治肺栓塞的实验研究

The application of 16-slice spriral CT in displaying the inferior vena cava filter in acute deep vein thrombosis animals

目的:探讨16层螺旋CT在腔静脉滤器植入防治肺栓塞治疗中的应用价值。方法:20条家犬分为实验组15条,空白对照组5条。实验组分别于滤器植入术前、术后用16层CT行肺动脉与深静脉联合造影。术前观察下腔静脉及其属支解剖位置。术后经股静脉插管植入滤器并注入血栓,观察下腔静脉及远端静脉内血栓显影情况及滤器植入位置和肺动脉显影。对照组不放滤器,同法注射血栓,CT扫描观察肺栓塞情况。结果:15例犬模型术前检查腔静脉及下肢深静脉显影良好。下腔静脉血栓CT值为(77±5.7)HU,肺动脉CT值为(330±9.3)HU,深静脉CT值为(172±8.5)HU,血栓与深静脉CT值具有显著性差异(t=56.04,P<0.001)。对照组均发生肺栓塞。结论:16层螺旋CT肺动脉联合深静脉扫描对介入手术入路选择及滤器正确放置能提供指导作用,并在术后监测中有较大的应用价值。

Objective：To discuss the application of 16-Slice spiral CT in acute DVT （deep vein thrombosis） dog-modules treated with IV C （inferior vena cava） falter. Methods：20 dogs were seperated into experimental group （EG, 15 dogs） and contol group （ CG, 5 dogs）. The EG underwent combined CT venography and pulmonary angiography on 16-slice CT twice （before and after the IVC operation）. Before the second scanning, the exosomatic thrombus were injected though femoral vein catheter to make the acute DVT module. The CG recovied thrombus without IVC.The parameters as following： total contrast volume 30 ml, injection rate 2 ml/s and 1 ml/s （two-phase, from cephalic vein of the front limb）, delay time for CTV 120s, and the scan for CTPA was triggered by bolus tracking （triggering CT value 100HU） ; collimation 0.6mm. Scan range of CTV： from popliteal fossa to the upper pole of the left kidney. Postprocessing included MPR, MIP, and VRT. Results：The IVC and pelvic and thigh veins images had good coincidence with conventional angiography during the IVC operation.The mean CT value of thrombus and venous vessels were （77 ± 5.7） HU and （ 172 ± 8.5） HU respectively, which showed significant difference （ t =56.04, P 〈 0.001）. MPR was good at showing small thrombus.Conclusion： 16-slice spiral CT angiography can provide accurate anatomic information about the IVC and pelvic and thigh veins, also, can be used to monitor the situation after the IVC filter operation.