猪肠系膜上动脉的MSCTA与DSA的对照研究

Comparative study of MSCT and DSA for demonstration of superior mesenteric artery in porcine model

目的:评价猪肠系膜上动脉多层螺旋CT血管造影(MSCTA)的可行性及在栓子定位中的价值。方法:24只巴马猪行MSCTA及DSA检查,12只DSA检查结束后行SMA二级分支栓塞。采用容积再现(VR)、最大密度投影(MIP)、薄层最大密度投影(TSMIP)进行血管三维重建,比较不同重建方法对肠系膜上动脉及其分支的显示能力差别。以DSA为金标准,评估MSCTA在栓子定位中的价值。结果:MSCTA可清晰显示肠系膜上动脉解剖特征,VR及MIP图像均可显示血管主干及一级大分支,19例可显示二级分支,TSMIP可显示末端分支至肠壁周围血管网。MSCTA显示栓子的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为100%、85.3%、94.5%、91.9%、100%。结论:MSCTA可以较为准确的显示猪肠系膜上动脉三维解剖学解剖特征及病变,有助于肠缺血等动物模型制作及介入实验研究。

Objective：To evaluate the feasibility of superior mesenteric（SMA） angiography and localization of the embolism on porcine model by multi-slice computed tomographic（MSCT） angiography.Methods：24 porcine models were undergone contrast-enhanced MSCT scans of whole abdomen and DSA examinations.12 cases were undergone embolization of the second-grade SMA branches.CT angiograms of SMA were reconstructed with volume rendering（VR）,maximum intensity projection（MIP）,thin-slab maximum intensity projection（TSMIP）.Various reconstruction techniques were compared and the ability of MSCTA in identifying embolism was evaluated.Results：MSCTA clearly displayed the anatomical features of SMA.Both of VR and MIP images could display the trunks and the first-grade branches of SMA,of which 19 cases could display the second-grade branches.TSMIP could diplay the terminal branches,even the capillary network of the intestinal wall.MSCTA is reliable in detecting embolism of SMA,and the sensitivity,specificity,accuracy,positive predictive value,negative predictive value were 100%、85.3%、94.5%、91.9%、100%,respectively.Conclusion：MSCTA can clearly visualize the anatomical features and lesions of SMA in porcine model which would provide a useful tool for experimental models and interventional treatment.