MSCTA在肠系膜动脉间吻合支成像上的应用价值

Multi-slice CT angiography of the anastomotic branch between mesenteric arteries

目的评价多层螺旋CT血管造影（MSCTA）对肠系膜动脉间吻合支的显示能力，研究肠系膜动脉间吻合支的三维影像解剖特点及其临床价值。方法分析2009年10月～2013年2月，无血管狭窄或闭塞、无手术、血管介入栓塞史，行全腹部多层螺旋CTA病例73例，男31例，女42例，年龄13～85岁，平均60．5岁。采用容积再现（VR）、薄层最大密度投影（TSMIP）对胰十二指肠动脉弓、空肠动脉弓及Riolan动脉弓的交通吻合支，进行重建重组、观察、测量。结果73例中，胰十二指肠动脉弓吻合支连接部，TSMIP显示64例，VR显示33例，其动脉直径0．7—1．5mm，平均1．3±0．18mm；空肠动脉弓吻合支连接部，TSMIP显示73例，VR显示26例，其动脉直径0．5—1．51mm，平均1．2±0．23mm；Riolan动脉弓吻合支连接部，TSMIP显示38例，VR显示0例，其动脉直径0．6～1．5mm，平均1．3±0．16mm。在显示肠系膜动脉间吻合支连接部方面，TSMIP优于vR。结论MSCTA三维成像TSMIP能较好地显示肠系膜动脉间吻合支连接部的解剖学特征，为临床治疗方案的制定提供参老依据。

Objective To evaluate the efficacy of multi-slice spiral CT angiography （CTA） in demonstrating the anastomotic branches between mesenteric arteries. Methods Eventy-three patients （31 men, 42 women, age range： 13-85 years, mean 60.5 years ） without stenosis of the celiac, superior and inferior mesenteric arteries underwent abdomen CTA. The pancreaticoduodenal arterial arcade, jejunal arterial arcade and arch of Riolan were reconstructed with volume rendering （VR）, maximum intensity projection （ MIP ）, thin-slab maximum intensity projection （TSMIP） and multiplanar reconstruction （ MPR ） methods. The visibility of the anastomotic branches using various reconstruction techniques was compared and the diameters of the arteries were measured. Results The pancreaticoduodenal arterial arcade was demonstrated in 64 patients with TSMIP and in 33 patients with VR. The diameters of the anastomotic branches were 0.7-1.5 mm with an average of 1.3 ±0.2 mm. The jejunal arterial arcade was visible in 73 patients with TSMIP and in 26 patients with VR. The diameters of the anastomotie branches were 0.5-1.5 mm with an average of 1.2 ±0.2 mm. The arch of Riolan was depicted in 38 patients with TSMIP and in none of the patients with VR. The diameters of the anastomotic branches were 0.6-1.5 mm with an average of 1.3 ±0.2 mm. TSMIP was superior to VR in displaying the anastomotic branches. Conclusions The TSMIP reconstruction of CTA can clearly show the anastomotic branches between mesenterie arteries and is valuable for interventional treatment.