多排螺旋CT直接法与间接法成像用于下腔静脉测量的对比研究

The Comparison of Inferior Vena Cava by Direct and Indirect 64-slice spiral CT Phlebography

目的:通过64排螺旋CT直接法成像所得下腔静脉各平面径线、CT值及图像质量与间接法下腔静脉成像进行对比,分析下腔静脉直接法CTP是否存在优势。方法:回顾性分析30例直接法下腔静脉成像的患者图像,收集30例腹部增强检查患者静脉期图像,通过GE adw4.6后处理工作站对原始图像进行重建,分别测量下腔静脉右心房入口、第一肝门、肾盂、左右髂总静脉分叉平面的长径及短径并测量CT值,两名具有5年以上影像诊断经验的医师分别对下腔静脉图像质量进行评价。两组结果进行比较及统计学分析。结果:下腔静脉右心房入口、第一肝门、肾盂、髂总静脉分叉上方平面的长径及短径,直接法成像分别为(3.02±0.44,2.06±0.32)、(2.29±0.49,1.39±0.52)、(2.46±0.44,1.73±0.45)、(2.30±0.38,1.66±0.46),间接法成像分别为(2.88±0.43,1.95±0.31)、(2.37±0.59,1.17±0.37)、(2.28±0.32,1.63±0.31)、(2.25±0.21,1.47±0.34),两组之间差异无统计学意义;直接法与间接法各平面所测得CT值分别为(232.57±59.45)、(278.10±80.00)、(360.32±92.13)、(466.78±100.71)HU,(122.45±16.10)、(107.10±13.32)、(92.46±12.93)、(88.23±12.62)HU,两组之间差异具有统计学意义,直接法远高于间接法;图像质量直接法成像良及以上者占93.3%,远高于间接法成像56.6%。结论:多层螺旋CT直接法下腔静脉成像切实可行且明显优于下腔静脉间接法成像,能够获得更好的图像质量用于诊断下腔静脉疾患。

Objective：By compare the inferior vena cava diameters,CT value,image quality of direct and indirect 64-slice spiral CT angiography , analysis whether there is an advantage of direct.Method：Collecting 30 cases which were underwent direct inferior vena cava phlebography;and collecting 30 cases of whole abdominal contrast enhanced CT, get the venous phase image.Original datas were transferred to GE adw4.6 workstation for post-processing.The major axis、minor axis 、CT value were individually measured, at the levels of its entrance to the right atrium, the portahepatis, the renal pelvis, above the junction of iliac vein.The image quality of inferior vena cava （IVC） was evaluated by two physicians with more than 5 years experience.The results of the two groups were compared and statistically analyzed.Result：At the levels of its entrance to the right atrium, the portahepatis, the renal pelvis, above the junction of iliac vein, the major axis, minor axis of direct CT phlebography individually were （3.02±0.44, 2.06±0.32）, （2.29±0.49, 1.39±0.52）, （2.46±0.44, 1.73±0.45）, （2.30±0.38, 1.66±0.46）, of indirect phlebography individually were （2.88±0.43, 1.95±0.31）, （2.37±0.59, 1.17±0.37）, （2.28±0.32, 1.63±0.31）, （2.25±0.21, 1.47±0.34）, there is no obviously difference between them.The CT values of direct CTP were （232.57±59.45）、（278.10±80.00）、（360.32±92.13）、（466.78±100.71）HU, much higher than the indirect CTP （122.45±16.10）、（107.10±13.32）、（92.46±12.93）、（88.23±12.62）HU.Image quality better than good of direct CTP is 93.3%, much higher than indirect CTP 56.6%.Conclusion：Multi slice spiral CT direct CTP of IVC is feasible and superior to indirect CTP.It can obtain better image quality and can be used to diagnose the IVC diseases.