64层螺旋CT脾动脉造影在腹腔镜巨脾切除术前检查中的应用

The Application of 64-slice Spiral CT Splenic Angiography Before Laparoscopic Splenectomy

目的评价64层螺旋CT脾动脉造影在腹腔镜巨脾切除术前检查中的应用价值。资料与方法回顾性分析行腹腔镜巨脾切除术前行64层螺旋CT脾动脉造影检查的32例患者的资料,其中原发性脾功能亢进3例,肝硬化脾功能亢进29例。血管成像方法包括容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)、曲面重组(CPR)。结果 32例患者脾动脉血管均明显增粗、扭曲;27例脾动脉走行于胰体尾部上缘,5例走行于胰腺后方;脾动脉分支型25例,主干型7例。脾动脉终末端多为二分叉型。发现脾动脉瘤8例共21处,其中5例为单发,3例为多发;位于脾动脉主干1处,位于脾叶动脉8处,位于脾内动脉分支12处。结论 64层螺旋CT脾动脉成像能够准确显示脾动脉生理及病理状态,为腹腔镜术前治疗方案的制订提供有价值的信息。

Purpose To investigate the value of 64-slice spiral CT splenic angiography in the patients with splenomegaly before laparoscopic splenectomy.Materials and Methods 64-slice spiral CT angiography was done in 32 patients with splenomegaly before laparoscopic splenectomy. Among the patients, there were 3 patients with primary hypersplenism and 29 with cirrhotic portal hypertension. 3D reconstruction technique included volume rendering （VR）, maximum intensity projection （MIP）, multi planar reconstruction （MPR） and curved planar reconstruction （CPR） was done for all the subjects.Results The lienal artery was obviously thickening and winding in all patients. It located above the pancreatic body and tail in 27 cases, behind the pancreatic tail in 5 cases. Twenty-five cases were categorized as branch type, and 7 were stem type. Twenty-one aneurysms were found in 8 patients. 5 were single and 3 were multiple. The aneurysm located at lienal artery in 1, at splenic lobe artery in 8, and inside the spleen in 12.Conclusion 64-slice spiral CT angiography is a feasible, accurate, and noninvasive method in the assessment of splenic artery, including physiological and pathoanatomical state. It is of great value to reasonable treatment options.