多层CT血管成像在肠系膜上动脉和静脉病变诊断中的应用  

Multi-slice CT angiography in the diagnosis of lesions of mesenteric artery and mesenteric vein

作　　者：谢江平[1] 言伟强[2] 刘进康[1] 周正明[1] 赵金山[1] 陈斌[1] 

机构地区：[1]中南大学湘雅医院放射科,长沙410008 [2]北京大学深圳医院医学影像科,广东深圳518036

出　　处：《中南大学学报（医学版）》2014年第6期612-617,共6页Journal of Central South University ：Medical Science

基　　金：深圳市科技计划项目(医疗卫生类)一般项目(201302067)~~

摘　　要：目的:评价多层CT血管成像在肠系膜上动脉(superior mesenteric artery,SMA)和肠系膜上静脉(superior mesenteric vein,SMV)病变中的应用价值,探讨显示病变的最佳方法。方法:本组共33例:SMA病变14例,其中血栓形成9例,夹层动脉瘤3例,假性动脉瘤1例,动脉旋转不良1例;SMV病变19例,均为血栓形成。多层CT血管成像均包括容积再现(volume rendering,VR)、最大密度投影(maximum intensity projection,MIP)以及多平面重建(multi-planner reformation,MPR)等重建方法。结果:9例SMA血栓形成在MIP均显示清楚,仅4例在VR显示病变,MIP对SMA血栓形成显示明显优于VR(P=0.0294)。3例SMA夹层动脉瘤以MPR显示较好,1例SMA假性动脉瘤和1例动脉旋转不良在VR显示较直观。19例SMV血栓形成在MIP和MPR均显示清楚,VR示病变血管不显像;其中12例SMV周围见侧支循环血管,侧支血管在MIP均显示良好,仅5例在VR显示,MIP对侧支血管显示明显优于VR(P=0.0046)。结论:运用多层CT后处理方法,能很好地显示SMA和SMV病变,在上述3种重建方法中MIP对SMA血栓形成及SMV周围侧支循环血管的显示最理想。Objective: To evaluate the value of multi-slice CT angiography(MSCTA) in the diagnosis of super mesenteric artery(SMA) and super mesenteric vein(SMV), and discuss the 3D reconstruction method for detecting mesenteric vessel lesions. Methods: Thirty-three patients suffering from mesenteric vessel diseases were analyzed. There were 14 SMA lesions, including 9 thromboses, 3 dissecting aneurysms, 1 pseudoaneurysm, and 1 malrotation. There were 19 SMV thromboses. The 3D reconstruction included volume rendering (VR), maximum intensity projection(MIP), and multi-planner reformation(MPR). Results: The lesions appeared clear by MSCTA in the 33 patients. The SMA thrombosis was shown clear in the MIP in all 9 patients, and only 4 of them were detected in the VR. There was significant difference between MIP andVR in detecting SMA thrombosis(P=0.0294). Three dissecting aneurysms were best shown in the MPR; 1 pseudoaneurysm and 1 malrotation were clearly manifested in the VR. The thrombosis of SMV was clearly shown by both MIP and MPR in all 19 patients. Collateral vessels were clearly shown in the MIP in 12 patients; the collateral vessels were detected by VR only in 5, and the other 7 failed to show the collateral vessels. There was significant difference between the MIP and the VR in showing lateral collateral vessels(P=0.0046). Conclusion: Both lesions of SMA and SMV can be detected by MSCTA. MIP is an ideal reconstruction method for SMA thrombosis and collateral vessels around the SMV.

关 键 词：肠系膜 血管造影术 体层摄影术 X线计算机 

分 类 号：R816.2[医药卫生—放射医学]