64层螺旋CT同步减影血管成像在颈部动脉狭窄诊断中的应用

Experience of synchronous subtraction 64-slice spiral CT angiography in diagnosis of carotid artery stenosis

目的探讨64层螺旋CT同步减影血管造影(CTA)在颈部动脉狭窄(包括颈动脉和椎动脉)诊断中的应用价值。方法对36例颈部动脉狭窄患者的三维血管成像作回顾性分析,采用容积重建(VR)、智能血管分析(vessel analysis)、最大密度投影(MIP)和多平面重建(MPR)技术对图像进行处理并综合比较各种重建技术。结果本组36例患者中,颈部动脉狭窄共48支。其中颈内、外动脉起始部轻度狭窄16例,中度狭窄5例,重度狭窄4例;颈动脉分叉处轻度狭窄18例,中度狭窄6例;颈总动脉起始处轻度狭窄4例,重度狭窄1例;椎动脉起始处轻度狭窄6例,中度狭窄2例。颈动脉闭塞:2例颈内动脉起始段完全闭塞。结论 64层螺旋CT同步减影血管造影在颈部动脉狭窄的诊断中具有较高的直观性和准确性,并具有较重要的临床应用价值。

Objective To evaluate accuracy and image value of 64-slice spiral CT synchronous subtraction angiography in diagnosis of carotid artery stenosis. Methods Thirty-six cases with carotid stenosis were analyzed retrospectively, MPR, VR and MIP were synthesized and various reconstruction technique was used. Results Among 36 cases, 48 branchs carotid artery steno- sis in total, 16 cases with slight degree of stenosis, 5 cases with medium degree of stenosis, and 4 cases with serious stenosis in the initiate part of internal and external carotid artery. There were 18 eases with slight degree of stenosis and 6 cases with medium degree of stenosis in carotid artery bifurcation. There were 4 cases with slight degree of stenosis and one case with medium degree of stenosis at the beginning of the common carotid artery. There were 6 cases with slight degree of stenosis and 2 cases with medium degree of stenosis in initiate part of ver- tebral artery. There were 2 cases with initiate part of internal carotid artery. Conclusion 64- slice spiral CT synchronous subtraction angiography can provide a direct-viewing and precise imaging of the carotid stenosis in diagnosis, and have the important value for clinical application.