两期不同主动脉CT血管造影对主动脉夹层显示价值的对比研究

Comparative Evaluation of Bolus-tracking and Delayed Scan CTA in the Detection of Aortic Dissections

目的对16层螺旋CT血管造影(CTA)在诊断主动脉夹层(AD)时应用智能追踪触发CTA扫描和延时扫描两期不同扫描方式所得的影像进行对比分析,探讨主动脉CTA对诊断AD的临床价值和几个技术要点。方法 2009年3月-2012年5月对28例疑似AD患者均采用扫描范围从胸廓入口到耻骨联合上缘水平CT平扫后,再行扫描范围相同的智能追踪触发CTA扫描和延时扫描两期不同的扫描,对两期不同扫描方式所得的影像结果进行对比。结果智能追踪触发CTA扫描进行后处理所得图像质量明显高于延时扫描,两期不同扫描对于内膜瓣、破口位置及真腔的显示差别不明显,延时扫描对某些慢性AD患者的假腔及血栓的显示能力优于智能追踪触发扫描,所以延时扫描对假腔的显示是对智能追踪触发扫描的重要补充。结论智能追踪触发扫描和延时扫描可以取长补短,两者结合可为临床提供更多信息。

Objective To verify the detection ability of 16-slice spiral CT angiography using bolus-tracking and delayed scan on suspected aortic dissection.Methods From April 2009 to May 2012,28 patients with suspected aortic dissection were evaluated with 16-slice spiral CT angiography using bolus-tracking and delayed scan after plain scan（from superior aperture of thorax to pubic symphysis edge）.Results The quality of image obtained by bolus-tracking was significantly better.But disparity in detection of intimal flap,break location and true lumen was very low.Delayed scan was better in the evaluation of false lumen for some patients with chronic aortic dissection.Conclusions Bolus-tracking and delayed scan have their own advantages.A combination of both can provide more information for clinical diagnosis.