血管生成、图像融合法容积重建出血性脑血管病变的价值

Add vessel and merge views of spiral CT volume to reconstruct the value of hemorrhagic cerebral vascular disease

目的探讨采用多排螺旋CT血管生成、图像融合法容积重建出血性脑血管病变的价值。方法采用16排螺旋CT进行头部容积扫描,利用"血管生长"及"图像融合"法对25例出血性脑血管病变的图像进行容积再现三维重建,分析出血性脑血管病变CTA的影像表现,评价其在出血性脑血管病变诊断和治疗中的优势和不足。结果 25例患者MSCT发现动脉瘤18例,显示瘤体、瘤颈、载瘤动脉和与周围血管及颅骨的关系清晰、确切;动静脉畸型(AVM)3例,显示畸形血管团的部位、大小、供血动脉来源,引流静脉的分支情况,空间立体结构清晰;静脉性血管畸形(CCVM)2例,不仅显示病灶特有的"海蛇头"征,而且完整地显示颅内静脉畸形的组成及引流静脉全程的三维影像;烟雾病1例,MSCT显示颈内动脉远段闭塞及近段Willis环血管渐进性狭窄,脑底部异常血管网形成;不明原因1例。结论多排螺旋CT采用血管生成、图像融合法进行脑内血管容积重现,能安全、可靠、快速、无创清晰显示脑血管病变,为临床诊断及治疗提供了可靠的信息。正逐渐代替或部分代替全脑血管造影检查,可作为自发性脑出血患者病因诊断的首选检查方法。

Objective To explore the value of add vessel and merge views of spiral CT volume to reproduce hemorrhagic cerebral vascular disease.Methods Using 16-slice spiral CT volume scan of the head,Volume rendering of the 25 cases of hemorrhagic cerebral vascular disease,image of blood vessel growth and image fusion method,Analysis of the performance of the hemorrhagic cerebral vascular disease CTA image,To evaluate the strengths and weaknesses of hemorrhagic cerebral vascular disease diagnosis and treatment.Results MSCTA,18 aneurysms,3 AVM,and,2 cerebral CVM were found in 25 patients,The aneurysmal body and neck,parent artery and relationship with adjacent vessels and skulls were displayed clearly and exactly by MSCTA,The position,shape,sources of the feeding artery,branch of the draining vein and stereochemical structure of the nidus of AVM were showed clearly.The sensitivity and specificity for MSCTA of detection of SAH with were 95% and 100%,respectively.Conclusion MSCTA,as a simple,fast,non–invasive,safe and reliable technique of Cerebral Angiography,can take place of DSA on some degree,and be regarded as the first choice on etiological diagnose of superacute SAH.