多层CT血管造影诊断脾动脉瘤的价值

Diagnosis of splenic artery aneurysms with multi-slice CT

目的:阐述脾动脉瘤的CT血管造影(CTA)表现,分析多层CT的诊断价值。方法:回顾性分析20例患者,其中仅1例因脾动脉瘤破裂而检查。CTA检查采用四层面螺旋CT机,准直为5 mm或2.5 mm,VR(容积显示)和TS—MIP(薄层块最大强度投影)重建。CT诊断标准为脾动脉局限性膨大1.5倍或以上且与正常脾动脉节段之间界限分明。结果:20例共检出脾动脉瘤28个,其中1例5个、1例3个、2例2个,其余均为单发。28个脾动脉瘤中18个位于脾门;14个有明确钙化,其中10个呈明显层状环形;1例破裂瘤体与周围界限不清,均未见血栓存在。瘤体最大为55 mm×48 mm,最小为17 mm×15 mm。VR清晰显示全部27个未破裂的脾动脉瘤,3例与血管造影显示一致,但其中1例5个瘤体者显示瘤体和载瘤动脉关系优于DSA。结论:多层面CTA能可靠、无创、立体地显示脾动脉瘤及与载瘤动脉等的相互关系。

Objective: To study the features of splenic artery aneurysms (SAA) in CT angiography(CTA) and to evaluate the diagnosis value of multi-slice CT. Methods: The CTA data of 20 patients with SAA were retrospectively analyzed. CTA was displayed with volume rendering(VR) and thin-slab maximum intensity projection(TS-MIP) in a 4-slice scanner. The diagnostic criteria of SAA was clearly demarcated enlargement of splenic artery(≥. 5 folds). Results: Twenty-eight SAAs were detected in 20 patients and the polyaneurysms were found in 3 cases (with 5, 3 and 2 aneurysms, respectively). Eighteen aneurysms located in splenic hili, 14 had calcifications(10 of them were laminated and circinate), and the ruptured one was ill-defined. No thrombus was found, the largest and smallest ones were 55 mm×48 mm and 17 mm×15 mm, respectively. VR clearly displayed all 27 unruptured SAAs. The angiograms in 3 cases were accordant with CTA, but was inferior to CTA in displaying the relationship between parent artery and the aneurysm body in the patient with 5 aneurysms. Conclusion: Multi-slice CTA can reliablely reveal the SAA and the relationship between parent arteries without invasiveness.