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目的探讨多层螺旋CT血管造影(MSCTA)及其三维重建在主动脉夹层动脉瘤的CT表现及诊断价值。方法收集72例行主动脉64排螺旋CT增强扫描的主动脉夹层动脉瘤病例,将MSCTA原始数据在ADW4.4工作站进行最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)、容积再现(VR)的主动脉血管重建处理,并将获取的资料进行综合分析,完成诊断。结果全部病例均很好地显示了主动脉全程及其主要分支血管,清晰地显示夹层动脉瘤的部位、范围、真腔、假腔、内膜片等,其中主动脉壁增厚钙化51例及附壁血栓39例也清晰显示。6例主动脉夹层患者经内支架置入术后复查,其支架位置、形态、膨胀程度及真假腔情况也得到满意显示。结论 MSCTA可清晰地显示主动脉夹层及主要分支血管的改变,为临床选择合理的治疗提供有价值的依据,是诊断夹层动脉瘤有效的检查方法,具有较高的临床应用价值。
Objective To investigate the CT findings and diagnostic value of multi-slice spiral CT angiography (MSCTA) and three-dimensional reconstruction in aortic dissection aneurysm. Methods A total of 72 cases of aortic dissecting aneurysms with aortic 64-slice spiral CT scan were collected. The MSCTA raw data were subjected to maximum density projection (MIP), multiplanar reconstruction (MPR), surface reconstruction (CPR) , Volume Reproduction (VR) aortic revascularization, and to obtain a comprehensive analysis of the data to complete the diagnosis. Results All the cases showed well the whole aorta and its main branch vessels, clearly showing the location, extent, true cavity, false lumen and intima of dissecting aneurysm, among which 51 cases were thickened aortic wall calcification and Thirty-nine cases of mural thrombus were also clearly shown. Six patients with aortic dissection were treated with endovascular stent placement. The position, shape, degree of swelling and the true and false cavities of the stent were also satisfactorily shown. Conclusion MSCTA can clearly show the changes of the aortic dissection and the main branch vessels and provide a valuable basis for clinical treatment. It is an effective method for the diagnosis of dissecting aneurysms and has a high clinical value.