肝脏螺旋CT血管造影──动脉系统三维成像初探

SPiral CT angiography of the liver──initial experience in three -dimensional imaging of arterial system

探讨螺旋ＣＹ肝脏动脉系统三维成像（ＳＣＴＡ－３ＤＡ）的效果及其临床价值。材料与方法２０例肝脏病人作了ＳＣＴＡ－３ＤＡＭＩＰ重建。采用１００ｍｌ造影剂，３ｍｌ／ｓｅｃ注射速度，２０－２２ｓｅｃ延迟扫描。扫描参数采用螺距１．５，准直３ｍｍ或５ｍｍ两组。有５例肝细胞性肝癌与ＤＳＡ成像作了比较。结果２０－２２ｓｅｃ延迟扫描可使腹主动脉段至肝动脉分支浓密显影。采用准直３ｍｍ，重建层厚１．５ｍｍ，可使ＳＣＴＡ－３ＤＡ达良好效果。良性及恶性病变显示供血肝动脉分级多为Ⅱ级以下管径不粗及Ⅲ级以上伴管径增粗，ＤＳＡ显示供血动脉均达Ⅳ级以上。结论采用合适扫描及造影技术可使ＳＣＴＡ－３ＤＡ重建肝动脉系统，并有助于良恶性质的鉴别。ＳＣＴＡ－３ＤＡ较ＤＳＡ成像空间分辨率差，但具有较好空间定位作用。

: Aim To investigate the efficacy and the clinical significance of spiral CT angiography with three - dimensional arterial imopng(SCTA - 3DA) of the liver. Materials and Methods By employing the method of maximum intensityprojection(MIP) for image reconstruction, SCTA - 3DA of foe liver was Performed for 20 patients with liver disease. 100 ml contrast media was administered in bolus mode with injection rate of 3 ndsecond. The scan delay time was 20 - 22 seconds, thespiral pitch was 1. 5 with two different collimation: 3mm or 5mm. The CT angiography images of 5 cases with hepatocellular car.cinoma were compared wilh findingS on digital subtraction angiopohy(DSA). ResultS 1. The scan delay time of 20 - 22 seconds enabled the dense opacification of abdominal aorta, hepatic alters and its intwhepatic branches; 2. Collilnation of 3 mmwas aPPropriate to obtain SCTA - 3DA images of hepatic alienal system with good qIJality. 3. For benign hepatic lesions, thesupplying artery could be visualized at the 2nd - oafer branches or below with nounal lumen caliber, while in cases of malignancy foe supplying artery was usually seen at the 3rd - oafer branches or above with abnormally dilated lurnen. DSA was ableto delineate foe 4Ih -- culer branches of hepatic altery. Conclusion With aPPropriate scanning parameters and proper contrasting teclmiqus, SCTA - 3DA can achieve excellent depletion of hepatic arterial system, which is helpful to the differentiation ofbenign and malignant hepatic lesions. Though the spatial resolution of SCTA - 3DA is not so good as that of DSA, it allowsmore accurate spatial localization of hepatic lesions