64层螺旋CT血管成像技术在主动脉夹层诊断中的应用

64-slice spiral CT angiography in the diagnosis and preoperative evaluation of the clinical value of aortic aneurysm

①目的探讨64层螺旋CT血管成像技术(CTA)在主动脉夹层(包括壁内血肿)诊断及术前评价中的临床应用价值。②方法对36例主动脉夹层(AD)患者行64层螺旋CT薄层扫描,在工作站采用最大密度投影(M IP)、多平面重建(MPR)及容积再现(VRT)技术对轴位图像进行三维重建。结合原始横断面图像分析。③结果 26例典型主动脉夹层:10例患者显示了一个或多个再破口,3例III型患者未显示明确的再破口,9例血型夹层患者初始破口位于主动脉弓降部或降胸主动脉近端,4例I型患者中,1例左颈总及左锁骨下动脉受累、3例左锁骨下动脉受累,右肾动脉受累者4例、左肾动脉受累者2例、腹腔干动脉受累者4例、肠系膜上动脉受累者3例。10例壁内血肿包括I型2例,III型8例。所有患者血肿区域均未见撕裂内膜片显示及对比剂进入血肿内,2例可见到一个或多个PAU形成,1例III型并发腹主动脉远端内膜撕裂。④结论 64层螺旋CT血管造影具有无创、快速、准确性高等优点,是主动脉夹层诊断及术前评价首选的影像学检查方法之一。

Objective To investigate the 64-slice spiral CT angiography in the diagnosis and preoperative evaluation of the clinical application.Methods 36 patients with suspected aortic aneurysm patients the continuity of a 64-slice GE helical CT and high concentrations of iodine contrast agent（370mgI/mL） angiography,of which patients were diagnosed as aortic aneurysm,so images of patients with analysis were done on the workstation,reconstruction techniques include multi-planar reconstruction（MPR）,maximum intensity projection（MlP） and volume rendering techniques（VRT）,Surface Reconstruction（CPR）.Results 26 patients,including five holidays aneurysm,10cases of true aneurysm.3 cases aneurysm,1 case in the ascending aorta and proximal aortic arch in 2 cases,2 cases in the abdominal aorta.53 true aneurysm,including 15 cases of ascending aortic aneurysm,38 patients with abdominal aortic aneurysm.Conclusion 64-slice spiral CT angiography with a non-invasive,rapid,high accuracy of the advantages of aortic dissection is a diagnosis and preoperative evaluation of imaging examination of choice for one of the methods.