双源CT在颌面部脉管性病变诊断中的应用

Application of Dual-source CT in Diagnosis in Maxillofacial Vascular Anomalies

目的评价双源CT对颌面部脉管性疾病的的诊断价值。方法回顾性分析24例颌面部脉管性疾病患者的双源CT影像资料,原始数据应用MIP、MPR、VR及双能去骨后处理技术,其中13例儿童受检者使用虚拟平扫技术获得平扫图像。结果 24例颌面部脉管性疾病患者中,18例为血管瘤,分别发生在腮腺咬肌区6例,颊部3例,眶部2例,耳前2例,鼻部2例,唇部3例,CT平扫表现为皮下类圆形软组织密度肿块,其中3例可见静脉石,15例增强后可见持续不同程度明显强化,3例强化不明显或轻度强化;6例为血管畸形,表现为病变部位不规则明显强化异常血管团,MPR、VR可见迂曲增粗的供血动脉、引流静脉及侧支。结论双源CT去骨技术及后处理技术可以清楚显示颌面部病变及异常血管的细节,对诊断颌面部脉管性疾病具有诊断价值,同时双能虚拟平扫技术可减低儿童受检者的放射剂量。

Objective To evaluate the diagnostic value of Dual-source CT in maxillofacial vascular anomalies. Methods Twenw-four patients of maxillofacial vascular anomalies who underwent dual source CT were retrospectively analyzed.The reconstruction techniques included multi-planar reforrnation（MPR）, maximum intensity projection（MIP）, volume rendering（VR）and dual energy bone remove technology, and nonenhanced images of 13 children were obtained by using virtual non-contrast software.Results In 24 cases of maxillofacial vascular anomalies,18 cases were hemangioma, which occurred in parotideomasseteric region（n=6）, in buccal（n=3）, in orbital（n=2）, in front of the ear（n=2）, in nasal（n=2）, in lip（n=3）, in CT plain scan images, hemangioma appeared as subcutaneous round soft tissue mass with homogeneous and medium density, 3 cases accompanied with phleboliths, on contrast CT scan,15 hemangioma showed linear progressive enhancement in different degree,when 3 cases showed not or slight enhancement, 6 cases were vascular malformation, all vascular malformation showed abnormal vascular plexus with irregular significant enhancement, and feeding arteries, drainage veins and collateral vessel were seen in MPR, VR images. Conclusion Dual source CT bone remove technology and post processing technique can clearly display the details of maxillofacial lesions and abnormal vessels. Dual source CT has significance diagnostic value in maxillofacial vascular anomalies, Dual energy virtual non-contrast software can reduce the radiation dose of children.