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目的:探讨大动脉瘤螺旋CT 血管造影(SCTA) 检查技术和应用价值,为合理选择SCTA 和DSA 检查方法提供依据。材料和方法:34 例大动脉瘤,均行SCTA 和DSA 检查,其中29 例经手术证实,术后7 例随访检查用SCTA。SCTA用最大强度投影( MIP) 和表面遮盖显示(SSD) 两种方法重建血管。结果:胸主动瘤10 例,腹主动脉瘤15 例,胸腹主动脉连续性动脉瘤2 例,髂动脉瘤7 例。SCTA 和DSA 均能较好地显示大动脉瘤的部位、形状、范围及夹层情况。MIP 重建图像能显示动脉壁钙化,SSD 重建图像能较好地显示动脉瘤的三维形态,SCTA 结合CT 横断面及多平面重建图像可更清楚显示动脉腔、动脉壁、附壁血栓及动脉周围组织结构。DSA 图像空间分辨力较SCTA 高,但不能清楚显示动脉壁、附壁血栓及动脉周围组织结构。结论:对大动脉瘤可首选SCTA 检查以替代DSA 检查。
Objective: To explore the technique and value of spiral CT angiography (SCTA) in aortic aneurysms and provide a basis for the reasonable selection of SCTA and DSA. MATERIALS AND METHODS: Thirty-four cases of aortic aneurysms were examined by SCTA and DSA. Twenty-nine of them were confirmed by surgery. Seven cases were followed up for SCTA. The SCTA reconstructs blood vessels using both maximum intensity projection (MIP) and surface occlusion display (SSD). Results: Thoracic aortic aneurysm in 10 cases, abdominal aortic aneurysm in 15 cases, thoracoabdominal aortic continuous aneurysm in 2 cases and iliac aneurysm in 7 cases. SCTA and DSA can better display the location of the aneurysm, shape, scope and dissection. MIP reconstruction images can show calcification of arterial wall, SSD reconstruction images can better display the three-dimensional morphology of aneurysms, SCTA combined with CT cross-sectional and multiplanar reconstruction images can be more clearly show the arterial lumen, artery wall, mural thrombus and surrounding tissue structure. DSA image spatial resolution higher than the SCTA, but can not clearly show the arterial wall, mural thrombus and arterial tissue around. CONCLUSIONS: SCTA may be the preferred alternative to DSA for aortic aneurysms.