多层CT扫描及VR重建技术在腹主动脉下段动脉瘤中应用

Application of Multi-slice CT Scan and Volume Rendering Reconstruction Technique in Lower Abdominal Aortic Aneurysm

目的探讨多层CT扫描及容积再现重建技术在腹主动脉下段动脉瘤中应用价值。方法回顾性分析2009年1月-2015年我院肿瘤外科收治的经手术病理证实的30例腹主动脉下段动脉瘤患者临床病例资料,所有病例患者均进行了多层CT扫描,同时均采用容积再现及最大密度投影进行血管重建,对多层CT扫描及VR重建技术在腹主动脉下段动脉瘤中应用价值进行探讨。结果 30例病例患者均为腹主动脉下段动脉瘤,均清晰显示瘤体解剖结构,瘤体最大横径为3.51-4.26cm,病灶均起源于肾动脉开口以下,累及范围4-8cm;20例伴瘤体内附壁血栓,形态呈半月形3例,新月形7例,不规则形4例,环形6例;10例附壁血栓内可见斑点、斑块状钙化。容积再现图像可显示动脉瘤体腔大小、形态及其与分支血管关系,同时直接反应瘤体与周围组织空间结构,但对附壁血栓、瘤体破裂后血肿范围等显示不理想,最大密度投影重建图像显示30例病例患者中20例显示伴有不同程度附壁血栓,准确显示瘤体破裂后血肿范围,但对瘤体大小、形态及分支血管关系等较难在一次重建像上完整显示。结论多层CT扫描及容积再现重建技术在腹主动脉下段动脉瘤中有较高应用价值,临床中可将其作为腹主动脉下段动脉瘤的有效检查手段。

Objective To investigate the application value of multi-slice CT scan and VR reconstruction technique in lower abdominal aortic aneurysm. Methods The clinical data of 30 patients with surgically and pathologically confirmed abdominal aortic aneurysm who were admitted in our hospital between January 2009 and 2015 were analyzed retrospectively. All cases underwent multi-slice CT scan. Meanwhile, the volume rendering （VR） and maximum intensity projection （MIP） were used for vascular remodeling. The application value of multi-slice CT scan and VR reconstruction technique in lower abdominal aortic aneurysm was analyzed. Results All the 30 patients with abdominal aortic aneurysm clearly showed the anatomical structure of the tumors, and the maximum transverse diameter of the tumors was 3.51-4.26cm. All lesions were originated from sites below the renal artery opening, involving the range of 4-8cm, 20 cases were complicated with mural thrombus inside the tumors, including half-moon- shaped in 3 cases, crescent-shaped in 7 cases, irregular in 4 cases and annular in 6 cases; 10 cases of mural thrombus showed spotty and patchy calcification. In all cases, the size and shape of the aneurysm and the relationship between the aneurysm and branch vessels were displayed, and the spatial structure of the aneurysm and the surrounding tissues were directly reflected. However, the mural thrombus and hematoma range after aneurysm rupture can not be displayed clearlv. After MIP reconstruction, 20 cases of 30 cases showed complication with different degrees of mural thrombus. The hematoma range after aneurysm rupture was accurately displayed. However, the size and shape of the aneurysm and the relationship between the aneurysm and branch vessels were difficult to displayed completely, based on once reconstruction. Conclusion Multi-slice CT scan and VR reconstruction technique are of high application value in lower abdominal aortic aneurysm, which can be used as an effective means for the diagnosis of abdominal aortic aneurysm.