三维CT重建在血管瘤和血管畸形诊断及治疗中的价值

The value of three-dimensional CT angiography in the diagnosis and treatment of vascular lesions

目的:评价三维CT重建在辅助血管瘤和血管畸形的诊断及治疗中的价值。方法:选取2006年1月～2007年8月在我科就诊的皮肤软组织血管性疾病的患者26例,均利用双源CT进行三维CT重建的检查。根据三维CT重建的检查结果制订治疗方案。所有患者都经过手术治疗,术中直视下记录病变情况,验证检查结果的准确性,同时观察术中及术后并发症,术后病理结果验证诊断结果。随访半年观察有无复发。结果:术后病理结果与三维CT重建诊断完全符合。其中8例患者为静脉畸形,8例为动静脉畸形,10例为血管瘤。根据三维CT重建的诊断及病变结构的信息制订治疗方案。26例患者均治愈,无并发症,且随访半年无复发。根据术中直视结果与三维CT重建的影像表现,三维CT重建显示病变的准确率高,显示血管瘤、动静脉畸形、静脉畸形准确率之间无显著差异。结论:三维CT重建能够准确、直观的显示血管瘤及血管畸形的结构,对它们的诊断及治疗很有意义。这种技术可能成为一种有效的辅助诊断和治疗皮肤软组织血管性病变的方法。

Objective：This study was designed to evaluate the value of 3-D CTA in the diagnosis and treatment of vascular lesions. MethodS：This study involved 26 patients with vascular lesions of soft tissue, who were treated in our department from May, 2006 to August, 2007. All the patients underwent 3-D CTA by dual source CT and therapeutic plans were made based on their 3-D CTA images. We determined the accuracy rates of the picture 3-D CTA delineated. We observed the recurrence condition in the sixth month follow-up. Pathological examinations were also done to testify our diagnoses after surgeries. Results： All the radiological diagnoses were proven by pathology. Eight of the patients suffered from venous malformation, eight of them suffered from arteriovenous malformation, and ten of them suffered from hemangioma. All patients were cured without complications and recurrence. According to the operation records, the accuracy rates of the picture 3-D CTA delineated were high. There is no significant difference among hemangiomas, artefiovenous malformation, and venous malformations in the accuracy rate. Concluslon：Our study suggests that 3-D CTA is helpful in differential diagnosis of hemangiomas and vascular malformations, as well as providing a global overview of the lesions, and that 3-D CTA aids a lot in making therapeutic planning. This technique may be a common, convenient method for surgeons to diagnose and treat vascular lesions.