320排CT血管成像评价筛前动脉的初步探讨  

Initial evalution of anterior ethmoid artery by 320 row CT cerebral angiography:contrast study with DSA

作　　者：丁娟[1] 李国英[1] 张绪平[1] 李敏[1] 郁冰冰[1] 李胜辉[1] 孙钢[1] 

机构地区：[1]济南军区总医院医学影像科,250031

出　　处：《中华临床医师杂志（电子版）》2011年第13期3746-3750,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的初步探讨320排CT血管成像(CTA)对识别筛前动脉的走行及其与邻近结构关系的价值,为功能性内窥镜鼻窦手术(FESS)提供术前参考。方法回顾性分析32例临床怀疑脑血管疾病患者影像资料,所有病例均先后行320排CTA成像及选择性颈内动脉血管造影术[单侧加数字减影血管造影(DSA)3D-Innova数据采集],利用原始数据重建出筛前动脉CTA及DSA图像。计算DSA对筛前动脉的显示率,分析CTA对筛前动脉及骨性解剖标记(包括筛前动脉眶口、筛前动脉管及筛前动脉颅口)的显示情况。结果 DSA及320排CTA对筛前动脉的显示率分别为100%(32/32)及89.06%(57/64)。骨性标记在MPR上的显示率分别为:眶口100%(64/64)、筛前动脉管43.75%(28/64)、颅口100%(64/64)。结论 320排CTA能够较好地显示筛前动脉及邻近骨性结构,基本可以代替有创性DSA检查对筛前动脉进行术前评价。Objective To provide accurate identification of ethmoidal artery for the FESS,initial study on the recognition of ethmoidal artery and its relationship with adjacent structures in 320-row CT angiography(CTA) were investigated.Methods 32 patients with cerebrovascular disease were analyzed.All cases underwent 320 row CTA and selective carotid digital substraction angiography(DSA),and then the images reconstruction were done with Innova CT.Then the images of anterior ethmoid artery were reconstructed with Innova CT software of DSA and 320-row CTA.Comparision was conducted between the maximum intensity projection(MIP) images of DSA and CTA.It was assessed that identified abilities of AEA entire course in the ethmoid by means of DSA and CTA.And it was analysed that the bony anatomical landmarks(the bony notch in the medial wall of the orbit,the anterior ethmoidal canal and the anterior ethmoidal sulcus)for locating AEA by means of mutiplanar reformation(MPR).Results AEA entire course in the ethmoid was seen in 100%(32/32) and 89.06%(57/64) by means of DSA and CTA respectively.There was no significant difference between the two groups.By means of MPR,the bony notch in the medial wall of the orbit and the anterior ethmoidal sulcus were both detected in 100%(64/64),the anterior ethmoid canal in 43.75%(28/64).Conclusions 320 row CTA can be used to identify the anterior ethmoidal artery and the surrounding anatomic structures.320 row CTA can replace angiography in evaluation of the anterior ethmoid artery pre surgery so as to avoid injury on the anterior ethmoid artery.

关 键 词：体层摄影术 血管造影术 X线计算机 筛前动脉 

分 类 号：R765.23[医药卫生—耳鼻咽喉科]