16层CT多平面重建与容积再现技术对主动脉夹层的评价

Evaluation of 16-slice CT multi-planar reconstruction and volume rendering for aortic dissection

目的探讨16层CT多平面重建(MPR)与容积再现技术(VR)对主动脉夹层(AD)诊断的价值。方法经手术或DSA证实的AD患者43例,其中男性36例,女性7例;年龄29～78岁,平均年龄52.8岁。分析其16层CT征象,原始采集层厚为0.75mm,间隔0.75mm。MPR包括冠状位、矢状位和平行于主动脉弓的斜位,应用VR软件重建出立体三维图像。结果 43例患者中包括DeBakeyⅠ型13例,Ⅱ型2例,Ⅲ型28例(Ⅲa型11例,Ⅲb型17例)。Stanford分型法:A型15例,B型28例。MPR能直观显示夹层的整体形态、分支血管的走行及钙化,对夹层真假腔、内膜片和内膜初始破口的显示率高。VR立体感强,能清晰显示病变的全程及与分支血管的空间关系。结论充分应用16层CT的MPR和VR技术可以及早为AD患者做出正确的诊断,该技术应作为临床可疑患者的优选检查方法。

Objective To evaluate 16-slice CT multi-planar reconstruction（MPR） and volume rendering（VR） techniques on the diagnosis of aortic dissection（AD）.Methods A total of 43 AD patients confirmed by surgery or digital subtraction angiography（DSA） were enrolled,male 36,female 7,aged 29-78 years old,mean age 52.8 years old.The images of 16-slice CT were analyzed,and original acquisition thickness was 0.75 mm,intervals of 0.75 mm.The MPR included coronal agittal and oblique position parallel to aortic arch.The three-dimensional images were reconstructed with VR software.Results In 43 patients,13 cases were DeBakey typeⅠ,2 cases were type Ⅱ,28 cases were type Ⅲ（11 of type Ⅲa,17 of type Ⅲb）.Stanford classification method included 15 cases of type A and 28 cases of type B.MPR had visualized the whole form,branching blood vessels course and calcification,with higher display rate of true or false lumen of dissection,initial flap,and the initial tear.VR stereoscopic was showed the entire lesion and the spatial relationship with the branch vessels clearly.Conclusion It is demonstrated that the full application of CT MPR and VR techniques could early make the correct diagnosis for AD patients,and the technology should be preferred in AD patients with clinical suspicion.