内脏动脉狭窄闭塞侧支循环的多层螺旋CT血管成像

Multi-slice CT angiography of the collateral circulation in stenosis or occlusion of visceral arteries

目的:探讨腹腔动脉(CA)、肠系膜上动脉(SMA)、肠系膜下动脉(IMA)狭窄闭塞侧支循环在多层螺旋CT血管造影(MSCTA)中的表现。方法:搜集CA、SMA、IMA慢性狭窄闭塞行MSCTA检查的患者80例,采用容积再现(VR)血管添加技术(AV)对侧支血管进行选择性重建。结果:80例慢性期内脏动脉狭窄闭塞患者中SMA闭塞5例、狭窄10例,CA闭塞13例、狭窄19例,均显示前、后动脉弓侧支循环,发生率100%(46/46),直径分别为(3.4±0.17)和(3.6±0.15)mm,胰背动脉侧支循环发生率32.6%(15/46),直径(2.1±0.15)mm。33例IMA闭塞,均显示Riolan动脉弓,胰背动脉侧支循环发生率12.1%(4/33),1例直肠上动脉与直肠下动脉交通。结论:MSCTA AV重建能清楚显示慢性CA、SMA和IMA狭窄闭塞后侧支循环及其解剖细节。

Objective：To study the multi-slice spiral CT angiography （MSCTA） manifestation of collateral circula tion in the stenosis/occlusion of celiac artery （CA）. superior mesenteric artery （SMA） and inferior mesenteric artery （IMA）. Methods：Eighty patients with chronic stenosis/occlusion of visceral arteries underwent MSCTA, and their collateral blood vessels were reconstructed selectively with post-processing techniques including volume rendering （VR） or add vessel （AV）. Results：Of the 80 patients with chronic visceral arterial stenosis/occlusion, there were occlusion （5 cases） and steno sis （10 cases） of SMA;occlusion （13 cases） and stenosis （19 eases） of CA,all shown collateral circulation of the anterior and posterior arterial arcades （100~ ,46/46 patients）,the diameter was （3.4±0.17）ram and （3.6±0.15）ram respective ly; collateral circulation of the dorsal pancreatic artery was shown in 32.6 % （15/46 patients）, and the diameter was （2.1±0.15）ram. 33 patients had IMA occlusion,4 patients （4/33,12.1%） had dorsal pancreatic collaterals. The superior rectal artery communicated with inferior rectal artery was revealed in 1 case. Conclusion： The collateral circulation as well as their anatomic details in chronic stenosis/occlusion of CA,SMA and IMA could be clearly displayed on MSCTA AV reconstruc tion images.