多排螺旋CT血管成像及三维重建在主动脉夹层动脉瘤诊断中的应用价值

Multi-row Spiral CT Angiography and Three-dimensional Reconstruction in Diagnosis of Aortic Dissection

目的:探讨主动脉夹层动脉瘤(aortic disscctions,AD)的CT血管成像(CTA)表现在临床诊断中的应用价值。方法:12例AD患者行薄层连续容积扫描,后处理以多平面重组(multiplanar reformation,MPR)和容积再现技术(volumerendering,VR)为主,观察AD的显示情况。结果:MPR可观察主动脉弓受累情况,显示真假腔形态、血栓形成、内膜瓣破口入口及内膜与分支血管关系;VR能整体直观显示其空间情况。12例AD中内膜钙化内移3例,显示真假腔10例,血栓形成5例,显示内膜破口7例,假腔周围性钙化2例,主动脉局限性或广泛性增宽8例。结论:多排螺旋CT血管造影及三维重建可清晰显示夹层动脉瘤的全面解剖信息,对明确范围、分型,真假腔鉴别及临床治疗具有重要的应用价值。

Objective To explore the CT angiography（CTA） for the diagnosis of the aortic dissection（AD）.Methods Twelve AD patients underwent continuous thin-layer volume scanning,and then post processing with multiplanar reformation（MPR） and volume rendering（VR）was performed for the display of AD.Results MPR behaved well in displaying of the involved true and false lumens,thrombosis,intimal flap,entry tear and relationship between the endomembrane and the branch vessel.VR could demonstrated the space.In the 12 AD patients,3 ones were diagnosed with calcified aortic intima,10 ones with true and false lumens,5 ones of thrombosis,7 ones of intimal tear,2 ones of the peripheral calcification of the false lumen and 8 ones of localized or massive widening of aorta.Conclusion Multi-row spiral CT angiography and 3D reconstruction can display the anatomic details of AD clearly,including the scope,typing,discrimination of true and false lumens.