64排双源螺旋CT血管成像对心血管急危重症的诊断价值

The diagnostic value of double-source spiral CT angiography for acute and acute cardiovascular disease

目的:研究64排双源螺旋CT血管成像(MSCTA)对心血管急危重症的诊断价值。方法:回顾性分析113例胸腹主动脉、肺动脉、冠脉、血管性病变急腹症等急症患者的CT表现,所有病例行平扫和增强扫描,并利用多平面重组法(MPR)、曲面重组法(CPR)、最大密度投影法(MIP)、容积成像法(VRT)进行血管成像。结果:21例主动脉夹层并正确分型。主动脉穿透性溃疡30例,其中合并壁间血肿18例。22例腹主动脉瘤,有14例伴瘤体内附壁血栓,其中2例瘤体破裂,转运途中死亡。25例肺动脉栓塞,冠脉畸形5例,血管源性急腹症10例。结论:双源CT大螺距前瞻扫描,一站式MSCTA检查,可同时观察冠状动脉、肺动脉、胸腹主动脉及其分支图像,病变继发表现。图像后处理工作站多种后处理方法,如MPR、CPR、MIP和VRT等,可直观、多方位显示动脉管壁、管腔及其分支,以供临床诊断。同时显示心包、胸部、腹腔肠管、腹膜、腹膜后等处的伴随征象,综合一体进行诊断及鉴别诊断,无创、快捷、详实、准确的影像检查可为临床抢救及治疗提供可靠的依据,也为患者的生存及预后赢取了最宝贵的时间。

Objective To study the diagnostic value of 64 platoon double source helical CT angiography（ MSCTA） for cardiovascular emergency. Method A retrospective analysis of 113 cases of chest aorta,pulmonary artery,coronary artery and vascular lesions such as emergency CT manifestations in patients with acute abdominal pain,all cases line scan and enhanced scan,and USES the method of multi-plane reorganization（ MPR）,curved surface reconstruction method（ CPR）,maximum density projection（ MIP） and volume imaging method（ VRT） on vascular imaging. Results 21 cases of aortic dissection and correct classification. There were 30 cases of aortic penetration ulcer,including 18 cases of interwalled hematoma. Of the 22 patients with abdominal aortic aneurysms,14 patients had a thrombosis in the tumor,2 of which were ruptured and died in transit. Pulmonary embolism in 25 cases. Coronary deformity 5 cases. 10 cases of angiogenic acute abdominal disease. Conclusion Double source CT scanning with a one-stop MSCTA examination,can observe the coronary artery,pulmonary artery,thoracic aorta and its branch images,and the lesion secondary performance. Multiple post-processing methods,such as MPR,CPR,MIP and VRT,can be used to show the arterial wall,lumen and its branches in an intuitive and multi-directional manner for clinical diagnosis. Also show the pericardium,chest,abdominal cavity bowel loops,peritoneal and retroperitoneal with signs,carries on the diagnosis and differential diagnosis,comprehensive integrated noninvasive,fast,detailed and accurate imaging can provide reliable basis for clinical rescue and treatment,also for the survival and prognosis of patients with won the most valuable time.