64排128层VCT在头颈部CTA中检查技术及成像技术探讨

Discussion on the inspection techniques and imaging techniques of 64-row 128-slice VCT angiography in intracranial and cervical arteries

目的探讨64排128层VCT在头颈部CTA中的检查技术及各种后处理技术的应用,以提高头颈部血管二维、三维显示率及病变的检出率。方法 (1)收集疑似头颈部血管疾病患者153例,将前60例患者随机分成A、B两组,每组各30例,均应用小剂量预实验法(Test Injection软件)扫描,A组采用常规CTA检查技术(直接增强容积扫描),B组采用数字减影CTA检查技术(平扫和增强2次容积扫描),完成数据采集;余下93例采用数字减影CTA检查。(2)图像后处理,扫描后进行多平面重组(MPR)、曲面重建(CPR)、最大密度投影(MIP)、容积再现(VR)、仿真内窥镜(VE),评价三维血管的质量,探讨各种后处理技术的应用价值。结果 (1)A、B两组均能显示头、颈部动脉血管,B组图像质量最佳,A、B两组质量差异具有统计学意义。(2)MPR可以同时显示轴位、矢状位和冠状位及任意斜位,并可改变重建的位置和层厚以观察细微的血管;VE能从血管内部立体显示夹层的破口、撕裂范围;CPR可以很好的显示血管的狭窄、闭塞、钙化、分叉位置;MIP可以真实反映颈动脉的实际CT值,很好的显示血管内部病变;VR可获得真实的头颈部动脉血管三维影像,很好的显示血管的走形、位置、关系。结论利用Test Injection扫描软件,采取数字减影CTA的检查技术操作简便、快捷;MPR、CPR、MIP、VR、VE技术的相结合可以获得满意的图像质量。

Objective To investigate the application of 64-row 128-slice VCT in the inspection techniques and all kinds of post-processing techniques of CTA in intracranial and cervical arteries to increase the two-dimensional（2D）and three dimensional（3D）display rate of vessels and the detection rate of lesions.Methods（1）153cases suspected intracranial and cervical arteries disease were collected,in which 60 patients scanned by small doses pre-experiments（Test injection software）were divided into group A and group B with 30 patients in each group.Regular CTA（only contrast-enhanced VCT scanning）were performed in group A.Digital subtraction CTA（non-contrast and contrast-enhanced VCT scanning）were performed in group B.The other 93 patients were performed with digital subtraction CTA scanning.（2）After scanning,the image post-processing of multi-planar reformatting（MPR）,curve planner reconstruction（CPR）,maximum intensity projection（MIP）,volume rendering（VR）,virtual endoscopy（VE）were used to evaluate the 3Dimaging quality of vessels and discuss the value of post-processing technology.Results（1）Intracranial and cervical arteries were all displayed in group A and Group B,but the images quality in Group B was better,the difference between Group A and B had statistical significance.（2）MPR could display images of axial,sagittal,coronal,arbitrary oblique and also could change the location and thickness of the reconstruction make it easy to observe some tiny blood vessels.VE could display the tear and range of dissection from internal vascular.CPR could clearly display the stenosis,occlusion,calcification and bifurcate position of vessels.MIP could reflect the true CT values of carotid artery and the internal lesions of vessels.VR technique could obtain true 3Dimages of intracranial and cervical arteries and display the shape,position and relationship of the vessels.Conclusion Test injection scanning software and digital subtraction CTA technology are simple and fast;Combined MPR,CPR,MIP,VR,and VE technology can obtain satisfactory images.