主动脉弓分支相关变异的多层螺旋CT研究

Variation of Aortic Arch Branches Displayed by Multi-Slice CT Angiography

目的分析多层螺旋CT血管成像(CT angiography,CTA)对主动脉弓凸侧分支血管的显示,观察主动脉弓分支的相关变异。方法搜集颈胸结合部CTA患者237例,采用容积再现(VR)和多平面重组(MPR)等多种图像后处理技术,获得主动脉弓部重组图像。多角度、多平面、多方位立体观察主动脉弓及其主要分支的解剖结构,分析主动脉弓分支的相关变异情况。结果主动脉弓分为两种类型,即:标准型和变异型,以标准型最常见,占总病例数的89.03%;变异型占总病例数的10.97%,其中可见4种不同类型的变异。左侧椎动脉自主动脉弓发出并位于左颈总动脉(left common carotid artery,LCCA)和左锁骨下动脉(left subclavian artery,LSA)之间者占变异型患者的50%,为总病例数的5.49%;LCCA自头臂干(brachiocephalic trunk,BT)发出者占变异型的38.46%,为总病例数的4.22%;LCCA发自于BT并存左椎动脉发自主动脉弓并位于LCCA和LSA之间者占变异型的7.69%,为总病例数的0.84%;右位主动脉弓伴迷走左锁骨下者占变异型的3.85%,为总病例数的0.42%。结论多层螺旋CTA能为临床提供主动脉弓变异的解剖信息。

Objective To observe the variation of aortic arch branches on the convex side of aortic arch analyzed by multi slice CT angiography（MSCTA）.Methods Based on the selection criterion,237 cases underwent neck and thorax multi slice spiral CT angiography（SCTA） examination were collected.aortic arch reconstruction images were obtained using volume rendering（VR） and multi-planar reconstruction（MPR） image processing techniques..The variation of aortic arch and its major branches were observed on images.Results Aortic arch was divided into the standard type（89.03%） and variant type（10.97%）.The standard type was the most common type.Four different variant types were found：（1）Left vertebral artery derived from aortic arch and located between left carotid artery and left subclavian artery,which accounted for 50% of the variant and 5.49% of the total cases;（2） Left carotid artery derived from brachiocephalic artery,which accounted for 38.46% of the variant and 4.22% of the total cases;（3）Left carotid artery originated from brachiocephalic artery,as well as left vertebral artery originated from the aortic arch and located between left carotid artery and left subclavian artery,which accounted for 7.69% of the variant and 0.84% of the total cases;（4） Right aortic arch and vagal left subclavian artery,which accounted for 3.85% of the variant type and 0.42% of the total cases.Conclusion MSCTA can display the anatomy and variation of aortic arch for clinical practice.