64排螺旋CT动脉血管造影在头颈血管病变空间定位及测定方面的意义  

64-slice spiral CT angiography for spatial localization and measurement of cephalocervical angiopathy

作　　者：贾洪顺[1] 全显跃[1] 王显龙[1] 黄志平[1] 盛娜萍[1] 

机构地区：[1]南方医科大学珠江医院放射科,广东省广州市510282

出　　处：《中国组织工程研究与临床康复》2007年第40期8196-8200,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:64排螺旋CT头颈血管造影包含信息庞大,针对几种常见头颈血管病变的临床应用体会进行初步总结,更好地发挥多排螺旋CT头颈血管造影在头颈血管病变诊断、测量和空间定位等方面的优势。方法:搜集2006-05/2007-05南方医科大学附属珠江医院行64排螺旋CT头颈动脉血管造影120例患者的影像资料。男89例,女31例,年龄19～67岁。全部患者行64排螺旋CT头颈血管造影,36例患者同时行头颈动脉数字减影检查。实验仪器:CT机采用Philips公司Brillance64排螺旋CT扫描仪,数字减影机采用siemens公司Axiom-Artis平板数字减影仪。结果:120例患者中颈内动脉和椎基底动脉狭窄病例88例,脑动脉瘤22例,脑动脉畸形10例。88例动脉狭窄病例发现中度狭窄区223处、重度狭窄区68处;291处中重度狭窄区共发现187(64%)个斑块,其中钙化斑块121个(65%),软斑块15个(8%),混合斑块51个(27%);钙化斑块CT值为324～596HU,软斑块值CT值为47～84HU;斑块表面不规则者114个(61%)。22例脑动脉瘤病例共发现29个动脉瘤,肿瘤最大直径4.5mm～2.7cm;囊状动脉瘤19例,梭形动脉瘤10例;动脉瘤起源颈内动脉10例,大脑中动脉7例,前交通动脉3例,大脑后动脉3例,起源后交通动脉、基底动脉和椎动脉各2例;2例合并部分血栓形成,3例合并出血。10例脑动脉畸形病例中8例显示有明确供血动脉,其中大脑前动脉供血为主3例、大脑中动脉供血为主2例、大脑后动脉供血为主3例;7例显示明确引流静脉,其中引流静脉主要汇入上失状窦3例,汇入横窦3例,汇入大脑深静脉2例;2例合并多发动脉瘤,2例合并出血。结论:64排螺旋CT血管造影在头颈血管病变的诊断、测量和空间定位中具有重要价值,可作为头颈血管病变首选检查方法。AIM： 64-slice spiral CT cephalocervical angiography （SCTA） provides large information. This article is designed to primarily summarize the clinical application of SCTA in cephalocervical angiopathy in order to fully play the advantages of SCTA in diagnosis, measurement and spatial localization of cephalocervical angiopathy. METHODS： 64-slice spiral CT angiographic data of 120 patients with cephalocervical angiopathy, who were treated at Zhujiang Hospital, Nanfang Medical University from May 2006 to May 2007, were analyzed. The 120 patients included 89 male and 31 female, aging from 19 to 67 years old. All of them received cephalocervical angiography. 36 of the 120 patients received digital subtraction angiography （DSA） of cephalocervical arteries. Laboratory apparatus included Brillance 64-slice spiral CT scanner produced by Philips Company and Axiom-Artis plate DSA produced by Siemens Company. RESULTS： Totally 88 patients of the 120 patients were with artedostenosis, 22 with aneurysms and 10 with cerebral arteriovenous malformation （AVM）. 223 middle stenosis lesions and 68 significant stenosis lesions were demonstrated in 88 patients with arteriostenosis, 187 of the 291 （64%） stenosis lesions were caused by formation of the intravascular plaques. 121 of the 187（65%）plaques were calcificated, 15（8%） were soft, and the other 51 （27%）were mixed ones. The CT value of the calcificated plaques and soft plaques were separately 324-596 HU and 47-84 HU. The surface of 114 （61%）plaques was irregular. 29 aneurysms were detected in 22 patients with aneurysm, and the maximal diameter ranged from 4.5 mm to 2.7 cm. 19 were cystogenic aneurysms and 10 were spindle aneurysms. 10 of the 29 aneurysms stemed from carotid, 7 from middle cerebral artery, 3 from anterior communicating artery, 3 from posterior cerebral artery, 2 from posterior communicating artery, 2 from basic artery and 2 from vertebral artery. There were 2 aneurysms complicated with formation of partial thrombus and 3 aneurysms

关 键 词：颈动脉狭窄 脑动脉瘤 脑动静脉畸形 多层螺旋CT 血管造影术 

分 类 号：R318[医药卫生—生物医学工程]