MSCTA对腹腔干狭窄及侧支循环的应用价值

Application of multi-slice spiral CT angiography in the diagnosis of celiac axis stenosis and its collateral circulation

目的:分析腹腔干狭窄的MSCTA表现,探讨MSCTA在诊断和评估腹腔干狭窄及侧支循环方面的价值。方法:回顾性分析经MSCTA的30例腹腔干狭窄患者的影像学资料,男23例,女7例,平均年龄53.7岁。所有病例临床病史均未提示腹腔干血管病变。分别对腹腔干血管狭窄的程度、侧支循环及有无并发腹腔内脏动脉瘤或肠系膜上动脉狭窄进行评估。结果:30例患者腹腔干起始段均狭窄,狭窄率45%～95%。22例伴有侧支循环(73.3%,22/30),共有28个侧支交通,其中胰十二指肠动脉弓型17个(60.7%,17/28),胰背动脉型6个(21.4%,6/28),肝内型1个(3.6%,1/28),肠系膜下动脉型4个(14.3%,4/28)。8例无侧支循环(26.7%,8/22)。30例腹腔干狭窄患者中合并肠系膜上动脉狭窄4例,合并腹腔动脉瘤3例。结论:MSCTA能够准确诊断和评价腹腔干狭窄及其伴发的侧支循环或腹腔内脏动脉瘤,具有重要的临床应用价值。

Objective： To analyze the multi-slice spiral CT angiography（MSCTA） appearances of celiac axis stenosis（CAS） and to assess its value in the diagnosis of CAS as well as its collateral circulation.Methods：The imaging data of 30 cases with CAS and its collateral circulation diagnosed by MSCTA were retrospectively analyzed,including 23 males and 7 females with the average age as 53.7 years.No clinical history of vascular disease of celiac axis was mentioned in all patients.The degree of CAS,collateral circulation,and the presence of associated aneurysm or superior mesenteric artery stenosis were evaluated.Results All of the 30 patients showed stenosis at the origin of celiac trunk,with the degree of stenosis as 45%~95%.22 patients showed collateral circulation（73.3%,22/30）,with a total of 28 collateral pathways,including pancreaticoduodenal arcade type（17/28,60.7%）,dorsal pancreatic artery type（6/28,21.4%）,intrahepatic type（1/28,3.6%） and inferior mesenteric artery type（4/28,14.3%）.No collateral circulation was revealed in 8 patients（8/22,26.7%）.Four patients associated with superior mesenteric artery stenosis,and three patients had abdominal splanchnic aneurysm.Conclusion：CAS and its collateral circulation or abdominal aneurysm could be accurately diagnosed and evaluated by MSCTA with important clinical value.