64层螺旋CT对主动脉根部形态结构的评价

Evaluation of morphologic characteristics of the aortic root with 64-slice spiral computed tomography

目的研究主动脉根部及临近组织结构64层螺旋CT(MSCT)成像技术、影像解剖及其临床意义。方法 60例无明显主动脉、主动脉瓣膜疾病患者行MSCT检查,采用多平面重建(MPR)、容积再现(VR)及仿真内镜(VE)等方法重建并测量相关数据。结果 测得主动脉根部直径(22.79±3.31)mm,主动脉窦间距(33.43±3.34)mm,冠脉开口处直径(30.06±2.70)mm,升主动脉内径(30.39±3.42),窦底平面至窦顶平面距离(19.18±2.21)mm。左右冠状动脉开口距主动脉根部距离分别为(15.71±3.53)mm、(15.96±3.78)mm。结论应用MSCT增强扫描可清楚显示主动脉开口大小、冠脉开口位置、有无发育畸形及与周边结构关系,为带瓣膜支架的设计与经皮主动脉瓣膜植入手术顺利施行提供影像学依据。

Objective To explore the imaging technique for demonstrating the aortic root and its neighbouring structures with 64-slice spiral computed tomography and to discuss the morphologic characteristics of the aortic root as well as their clinical significance.Methods Multislice spiral CT scanning was performed in sixty adult patients who had no obvious ascending aorta diseases or aortic valve abnormalities.Multi-plane reconstruction（MPR）,volume rendering（VR）and virtual endoscopy（VE）were employed to demonstrate the anatomy of the aortic root,while the relevant data concerning the aorta and coronary sinus were also determined.The results were analyzed.Results The mean aortic diameter at aortic root was（22.79 ± 3.31）mm,the mean distance between coronary sinuses was（33.43 ± 3.34） mm,and the mean coronary diameter at its orifice was（30.06 ± 2.70） mm.The measurements also included the inner diameter of middle ascending aorta（30.39 ± 3.42） mm,the distance between the bottom plane and top plane of the coronary sinus（19.18 ± 2.21） mm,the distance between left coronary orifice and aortic root（15.71 ± 3.53） mm and the distance between right coronary orifice and aortic root（15.96 ± 3.78） mm.Conclusion Enhanced multislice spiral CT scanning together with 3D reconstruction imaging can clearly demonstrate the size of the aorta,the location of coronary orifice,the vascular malformations and the anatomy of adjacent structures in detail,which effectively provide the interventional physician with reliable imaging information very helpful for the designing of covered stent as well as for the managing of percutaneous implantation of artificial aortic valve.