颅内血管延长扩张症的三维螺旋CT血管成像

Evaluation of 3D-SCTA in the Diagnosis of Intracranial Artery Dolichoectasia

目的 分析和探讨三维螺旋CT血管成像 (3D SCTA)对颅内血管延长扩张症 (ICAD)的诊断价值。材料与方法 对 5例ICAD患者进行 3D SCTA检查 ,其中男 3例 ,女 2例 ,年龄 3 5～ 70岁 ,平均 5 1.2岁。采用最大强度投影法 (MIP)、表面遮蔽法 (SSD)和虚拟内镜法 (VE) 3种方式重建三维图像。结果 ICAD的 3D SCTA表现 :(1)部位 :椎动脉 2例 ,基底动脉 1例 ,颈内动脉海绵窦段 2例。(2 )范围 :最长者自椎动脉管颅底段达基底动脉起始部 ,约 5 0mm ,最短者约 2 0mm。 (3 )形态 :1例颈内动脉海绵窦段呈螺旋状盘绕 ,2例椎动脉呈梭形膨大 ,另 2例为管状增粗并大幅度蜿蜒扭曲 ;(4)钙化 :病变血管钙化 2例 ,其中 1例呈多发性斑片状分布 ,另 1例为单发小片状钙化。结论 螺旋CT三维图像重建是一项无创、快速、简便的影像学方法。将三维CT血管成像与横断位像源CT表现相结合进行综合分析 ,有利于提高螺旋CT检查对ICAD的定位、定性及其相关并发症的诊断能力。

Objective To evaluate 3D-SCTA in diagnosing intracranial artery dolichoectasia (ICAD).Materials and Methods 3D-SCTA was performed in 5 patients with ICAD, including 3 males and 2 females, aged 35～70 (mean 51.2) years old. 3D reconstruction, including MIP, SSD and VE, was made. Results The findings of ICAD on 3D-SCTA were as follows: (1) affected vessel: vertebral artery (n=2), basilar artery (n=1) and carotid-cavernous fistula segment (n=2); (2) involved extent: 20～50 mm, the longest lesion affected the basicranial segment of vertebral artery up to the initial segment of basilar artery; (3) morphologic changes of diseased vessel: spiral and winding appearance (n=1), fusiform enlargement (n=2) or tubular widened (n=2); (4) vascular calcification: multi-scattered plaque-like (n=1) or small single plaque (n=1). Conclusion A combination of original axial images with 3D image reformation technique is very helpful for evaluating the affected vessels of ICAD.