256层螺旋CT血管成像后处理技术在脾动脉瘤诊断中的应用

目的探讨256层螺旋cT血管成像的后处理技术对脾动脉瘤的诊断价值。方法回顾性分析经手术证实的16例脾动脉瘤（共20个脾动脉瘤）患者的CTA资料，由2位副主任医师对图像进行容积再现（volume rendering，VR），最大密度投影（maximum intensity projection，MIP），多平面重组（multiplannar reconstruction，MPR）等后处理，分别计算VR、MIP、MPR、vR＋MIP＋MPR后处理技术诊断脾动脉瘤的灵敏度、特异度、误诊率、漏诊率和Youden指数。结果VR诊断脾动脉瘤的灵敏度94．74％、特异度75％、误诊率5．26％、漏诊率25％、Youden指数0．73。MIP分别为94．12％、60％、5．88％、40％及0．54。MPR分别为93．75％、54．55％、6．25％、45．45％及0．48。vR＋MIP＋MPR分别为95％、85．71％、5％、14．29％及0．81。结论256层螺旋CT血管成像的多种后处理技术的联合应用能显著提高脾动脉瘤的诊断。

Objective To evaluate the value of 256-slice CT angiography and different post-processings in the diagnosis of splenic aneurysm. Methods 16 patients with splenic aneurysm （ 20 splenic aneurysms total ） were retrospectively reviewed for their imaging findings. All of them were underwent 256-slice spiral CT angiography and data collected were processed using VR, MIP and MPR, the images were analysed by two experienced radiologists, the sensitivity, specificity, mistake diagnostic rate, omission diagnostic rate and the Youden index of the VR, MIP, MPR and all of them together were compared respectively.Results The sensitivity, specificity, mistake diagnostic rate, omission diagnostic rate and the Youden index in detection ofaneurysms were94.74%, 75%, 5.26%, 25%, 0.73 respectively withVR; 94.12%, 60%, 5.88%, 40%, 0.54 respectively withMIP; 93.75%, 54.55%, 6.25%, 45.45%, 0.48 respectively withMPR; 95%, 85.71%, 5%, 14.29%, 0.81 respectively with VR, MIP and MPR together. Conclusion The combination of the different post-processings of 256-slice spiral CT angiography can improve the diagnosis of the splenic aneurysm obviously.