各型主动脉瘤的64排CT多种重建图像的特征比较

Comparison of characteristics of 64-detector CT reconstruction images for aorta aneurysm

目的比较64排CT血管造影(MDCTA)的多种图像后处理重建技术显示各型主动脉瘤形态特征的能力。方法回顾性分析手术确诊的主动脉瘤患者65例的MDCTA资料,所有原始图像均行多平面重建(MPR)、曲面和管腔拉直图(CPR和LS)、最大密度投影(MIP)、表面遮盖(SSD)、CT内窥镜(CTVE)、容积再现(VR)重建,统计并比较每种重建图像中可以显示的与主动脉瘤诊治密切相关的图像特征。结果在主动脉瘤65例中,真性动脉瘤14例,假性动脉瘤13例,夹层动脉瘤38例,后者DebakeyⅠ型18例,Ⅱ型3例,Ⅲ型17例(Ⅲa型8例,Ⅲb型9例),与手术结果一致。VR及CPR和LS重建图像能最佳显示真性和假性动脉瘤的形态特征;CPR和LS,CTVE,VR对于显示夹层动脉瘤的形态特征最好;轴位图像对各类动脉瘤都具有重要价值。不同重建图像显示各型动脉瘤的形态特征不同,多种图像结合可以更准确的显示病变特征。结论MDCTA的多种图像后处理重建技术可准确诊断主动脉瘤并显示各型动脉瘤的形态特征;任何类型的动脉瘤的诊断都需以轴位原始图像为依据,同时结合重建图像最优显示其形态学特点。

AIM To evaluate the role of different 6d-detector CT reconstruction images in displaying the morphous characteristics of three types of aorta aneurysm. METHODS 64-detector CTA images of 65 surgery-proved aorta aneurysm cases were analyzed retrospectively and several kinds of image reconstructions were performed, including MPR （Multiplanar Reformat）, CPR （Curve plane Reconstruction）, Lumen strip, MIP （Maximum intensity projection）, SSD （Surface Shaded Display ）, CTVE （CT Virtual Endoscope） and VR （Volume Rendering）. The reconstruction image features valuable to aneurysm diagnosis and treatment were studied and statistically analyzed according aneurysm types. RESULTS ① Consistent with results of surgery, 14 cases were found true aneurysm, 13 cases pseudoaneurysm, 38 cases aorta dissection, among which 18 cases were Debakey type Ⅰ , 3 cases type Ⅱ , 8 cases type Ⅲa and 9 cases type rob. ②Images obtained by different reconstruction methods had their own merits in showing lesion morphous characteristics and combination of these images better displayed the features of aneurysm. The optimal ways to show true aneurysm and pseudoaneurysm were VR, CPR and LS images, while CPR, LS, CTVE and VR image were the best for aorta dissection. CONCLUSION 64-detector CT reconstruction images are sensitive and specific for the diagnosis of aneurysm. Axial image is the basis and can not be displaced in the diagnosis of any type of aneurysm.