多层螺旋CT血管成像在主动脉夹层动脉瘤诊断中的应用

Application of Multislice spiral CT angiography in the diagnosis of aortic dissection

目的:研究多层螺旋CT血管成像在主动脉夹层动脉瘤诊断中的应用。方法:对2010年9月至2012年1月12例主动脉夹层动脉瘤患者行多层螺旋CT,并进行回顾性分析,使用lightspeedTM16层及BrightspeedTM8层CT机进行扫描,再将得到的数据传输进工作站,在工作站采用曲面重建、多层面重建、表面阴影重建等对主动脉夹层动脉瘤采用三维重建。结果:在12例观察者中,有5例为DeBakeyⅠ型,3例为DeBakeyⅡ型,剩下的4例为DeBakeyⅢ型。有2例合并马方综合征的三维重建图像中有特征表现,1例主动脉重要分支受累。所有病例均能清楚显示出主动脉的全程和分支,真假腔内膜病变以及夹层动脉瘤位置和范围、管壁钙化情况,附壁血栓与病变的空间位置关系亦可以满意显示。仿真内镜能表现出内膜片和血管的关系及夹层动脉瘤内膜破口情况。结论:多层螺旋CT血管成像可以准确、迅速地诊断出夹层动脉瘤和其分型,协助临床制定相应治疗方案,为手术提供精准的解剖信息,对于评价血管的畅通性及明确有无血管内膜增生及有无支架变形有非常重要的临床意义,临床应广泛推广应用。

Objective： To study the application of multislice CT angiagraphy in the diagnosis of aortic dissection. Methods： From September 2010 to January 2012,12 cases of aortic dissection underwent multislice spiral CT,and retrospective analysis using lightspeedTM 16 layer and BrightspeedTM of 8 - slice CT scan, and then transfer data into the workstation, using three - dimensional reconstruction on aortic dissection by surface reconstruction, multi - dimensional reconstruction, shaded surface reconstruction in the workstation. Results：In 12 cases ,5 cases of DeBakey type I ,3 cases of DeBakey type II , and the remaining 4 cases of DeBakey type 11I. 2 cases of patients with Marfan syndromes were characterized in three - dimensional reconstruction image, and aortic branch was involved. All cases can clearly show the entire and branch of the aortic, true and false lumen intimal lesions as well as dissec- ting the location and extent of wall calcification,and mural thrombus and lesion spatial relationships can also be satisfied with the show. Virtual endoscopy can show the relationship of the intimal flap and vascular dissection intimal tear. Conclusion： The multi - slice spiral CT angiography can accurately rapid diagnosis of dissecting and genotyping to assist the clinical develop appropriate treatment programs, to provide precise anatomical information for the surgery for the evaluation of vascular smooth flow and clear whether the intravascular membrane proliferation and the presence of stant deformation there, is a very important clinical significance, clinical widely applications.