多层螺旋CT血管成像在大动脉炎中的应用  

Multi-slice CT angiography in the diagnosis of Takayasu's arteritis

作　　者：马祥兴[1] 张伟[1] 马晓峰[1] 王青[1] 于德新[1] 李笃民[1] 崔凤玉[1] 李传福[1] 

机构地区：[1]山东大学齐鲁医院影像中心,济南250012

出　　处：《中华放射学杂志》2007年第2期169-171,共3页Chinese Journal of Radiology

摘　　要：目的探讨多层螺旋 CT(MSCT)血管成像在诊断大动脉炎中的临床应用价值。方法对临床拟诊大动脉炎的14例患者进行 MSCT 血管成像,扫描范围自颈2椎体水平至耻骨联合水平,图像后处理方法包括多平面重组、最大密度投影、容积重组、血管内镜及血管分析,充分显示受累血管的部位、范围及程度。结果 14例患者 CT 表现为不同程度的动脉管壁增厚,管腔狭窄或闭塞,管腔狭窄具有向心性的特点,部分伴狭窄后扩张。按管腔情况包括狭窄-阻塞型8例,混合型6例。重组图像结合轴面图像观察,可以清晰显示受累大血管及其分支血管的狭窄程度或闭塞情况以及侧支血管形成情况。依据 Lupi-Herrea 分类法包括Ⅰ型5例,Ⅱ型2例,Ⅲ型6例,Ⅳ型1例,CT 结果均与其临床表现相符。结论 MSCT 血管成像同时显示大动脉炎的管腔情况和管壁改变,后者对于早期诊断及治疗、改善预后具有重要意义,可以作为此病的首选检查方法。Objective To evaluate the clinical value of multi-slice CT （MSCT） angiagraphy in the diagnosis of Takayasu＇s arteritis. Methods Fourteen patients underwent MSCT angiography with use of 90ml contrast media at a rate of 3. 5 ml/s. Images were generated for vascular assessment with various reconstructional techniques, including multi-planar reformat （ MPR）, maximum intensity projection （ MIP）, volume rendering （ VR）, CT virtual endoscopy （CTVE） and advanced vessel analysis （AVA）. Results MSCT angiography findings was consistent with the clinical changes of Takayasu＇s arteritis in all cases. The integrated information including reconstructional and transverse images clearly presented various luminal abnormalities, such as stenosis, occlusion and dilatation in the affected aorta, as well as its major branches and collateral circulation. Furthermore, it depicted mural abnormities, especially concentric arterial wall thickening. Steno-occlusive type （8/14） was more common than mixed type （6/14）. According to LupiHerrea＇s classification, type Ⅰ in 5 cases, type Ⅱ in 2, type Ⅲ in 6 and type Ⅳ in 1 were recorded in the present study. Conclusion MSCT angiagraphy is reliable imaging madality for the detection of Takayasu＇s arteritis. It is useful for early diagnosis because it allows evaluation of wall thickness rather than merely the luminal diameter, which is especially important for prognosis. It might be used as the first choice in the diagnosis of this disease as a simple, convenient and noninvasive method.

关 键 词：TAKAYASU动脉炎 体层摄影术 X线计算机 血管造影术 

分 类 号：R816.2[医药卫生—放射医学]