摘要
目的探讨螺旋CT血管造影(SCTA)后血管重建技术及CT仿真内窥镜技术对主动脉夹层的诊断价值。方法对17例主动脉夹层患者进行螺旋CT增强扫描,并进行二维及三维重建,包括表面覆盖成像(SSD)、最大密度投影重建(MIP)、多平面投影法(MPR)、曲面重建(CPR)及CT仿真内窥镜成像(CTVE)。结果SCTA横断面图像、MPR、CPR及CTVE均显示各例动脉夹层的真腔和假腔,剥离内膜及钙化,血栓亦能显示。MIP、及SSD能不同程度显示真腔和假腔及剥离内膜,能较好地显示主动脉病变的全貌,显示病变的范围、大小及分支血管受累情况。MIP可清楚显示血管管壁钙化;MPR可以对病变进行任意角度重建和观察,清楚地显示附壁血栓、真假腔、破口、钙化和内膜片;CPR可将不在同一平面的结构显示在同一二维平面上,但不能显示结构的纵深关系;CTVE能显示主动脉夹层的真腔和假腔、剥离内膜及破口。结论应用SCTA的各种成像技术,以横断图像为基础,结合其MPR、MIP、CPR、SSD及CTVE,能够较全面地显示主动脉夹层,一定程度上取代创伤性DSA造影检查,为主动脉夹层的诊断提供一种安全可靠的手段。
Objective To evaluate the value of reconstruction and virtual endoscopy of spiral CT angiography in diagnosing aortic dissection. Methods seventeen patients with aortic dissection were examined by spiral CT with contrast agent and the post processing included shaded surface display(SSD), maximum intensity projection(MIP), multiplanar reconstruction(MPR), curved planar reconstruction(CPR) and CT virtual endoscopy(CTVE). Results The true and false lumen, exfoliate intima, calcification, and thrombus could be seen on axial imaging, SCTA, MPR and CTVE. Both the panorama of atortic lesion including exfoliate intima, true and false lumen and its extent, size and involvoment of vascular branches could be preferably shown on MIP, CPR and SSD. Caicification of vasucular wall could be clearly displayed on MIP. The true and false lumen, exfoliate intima, calcification, thrombus and crevasse could be revealed on MPR because the whole lesion could be reconstructed and observed from any angle on it. Some structures, which were not on the same plane, could be shown on the same two dimensional plane, but their deep relations couldn′t be done. The true and false lumen, exfoliate intima and crevasse could also be seen on CTVE. Conclusion axial imaging combined with other imaging techniques of SCTA including MPR, MIP, CPR, SSD and CTVE will roundly display aortic dissection. SCTA will be a reliable and safe method in diagnosing aortic dissection and be able to replace invasive DSA on a certain extent.
出处
《影像诊断与介入放射学》
2004年第2期90-93,共4页
Diagnostic Imaging & Interventional Radiology
