摘要
目的探讨64层螺旋CT血管成像对胰腺直接供血动脉的显示价值。方法对91例非胰腺器质性病变行胰腺供血动脉64层螺旋CT造影检查,应用腹部容积扫描程序,采用最大密度投影法(MIP)和容积再现(VR)技术获得胰腺直接供血动脉图像,并以DSA造影结果为金标准进行比对,观察分析MIP、VR对胰腺直接供血动脉的显示率,并对其显示真实性、可靠性及收益进行评价;采用卡方检验比较两种方法间的差异性。结果 MIP和VR对胰腺直接供血动脉的显示率不同,MIP对胰十二指肠上前动脉、胰十二指肠上后动脉、胰十二指肠下前动脉、胰十二指肠下后动脉、胰背动脉、胰横动脉、胰大动脉显示率明显优于VR,经卡方检验,差异有统计学意义(P<0.05)。MIP对胰尾动脉显示率与VR间差异无统计学意义。而且MIP方法可提高胰腺直接供血动脉显示的敏感度、正确诊断指数和阳性预测值;但其对显示的特异度及阴性预测值与VR比较差异无统计学意义。结论 64层螺旋CT血管成像是一种简便、快速、无创显示胰腺供血动脉检查手段,能够显示胰腺直接供血动脉,并可为临床提供有价值的参考依据;MIP多角度三维重建能比VR更准确显示胰腺直接供血动脉解剖结构。
Objective To investigate the visual value of the feeding arteries of pancreas on arteriography with 64 detector row spiral CT.Methods Arteriography of the pancreatic feeding arteries with the 64 detector row spiral CT was performed for 91 patients with normal pancreas,and the data of feeding arteries of pancreas were reconstructed by MIP （Maximum intensity projection,MIP） and VR （Volume rendering）,and contrasted to the results by DSA which were the gold standard for comparison.The display rate of MIP and VR observed and analyzed in direct feeding artery of pancreas,and investigated the validity,reliability and predictive value.The least compared the difference between these two methods by chi-square test.Results There had obviously difference between MIP and VR in displaying the directly feeding arteries of pancreas.MIP was superior to VR in the visualization of direct feeding arteries of pancreas,and there was significant difference in visualization rates of ASPDA,PSPDA,AIPDA,PIPDA,DPA,PMA.There was no significant difference in visualization rates of CPA between MIP and VR.MIP could improve the sensitivity,Youden′s index and positive predictive value of displaying rate direct feeding arteries of the pancreas,but there were no significant difference in specificity and negative predictive value.Conclusions Pancreatic arteriography with the 64 detector row spiral CT is a rapid noninvasive method to depict the pancreatic arteries.Angiography of the direct feeding arteries of pancreas with 64-slice CT can provide valuable information for clinician.The anatomic features of the pancreatic arteries can be more accurately displayed by MIP reconstruction than VR.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第5期44-50,共7页
Chinese Journal of Clinicians(Electronic Edition)
