平板旋转血管造影及三维重组在主动脉病变中的应用  

Clinical Application of Three-dimensional Reconstruction Imaging with Rotational Digital Angiography Technique in Aorta Lesions

作　　者：唐向周[1] 杨向太[1] 李国业[1] 张群[1] 成佛金[1] 谈文开[1] 

机构地区：[1]广东省人民医院、广东省心血管病研究所心导管室,广州510080

出　　处：《放射学实践》2008年第12期1316-1320,共5页Radiologic Practice

摘　　要：目的:评价平板旋转血管造影及三维重组在主动脉病变临床应用的价值。方法:对比分析31例主动脉病变患者的CT或MR、二维血管造影、旋转血管造影及三维重组影像学资料,并对其结果对比分析。31例均为男性,年龄18～81岁,平均56.5岁。结果:行胸主动脉造影28例,发现主动脉夹层25例,动脉瘤1例,假性动脉瘤1例,主动脉弓畸形1例。行腹主动脉造影3例,发现动脉瘤2例,1例为腹主动脉动脉硬化性改变并主动脉钙化。所有主动脉夹层、真性及假性动脉瘤造影与CT或MRI对比,病变的形态、大小、位置均相符。其中有2例夹层的造影提示CT诊断破口位置错误。1例主动脉弓畸形,CT误诊为动脉瘤,而造影则可以清晰显示扩张纡曲的畸形主动脉弓。其中23例主动脉夹层和3例真性动脉瘤造影后进行支架主动脉腔内隔绝术的介入治疗,术后均行二维血管造影,支架位置准确,隔绝效果良好,没有出现并发症。结论:平板旋转血管造影及三维重组对主动脉病变的诊断和治疗有较高的临床应用价值,可以提高介入治疗的安全性和成功率。Objective：To evaluate the clinical application value of three-dimensional （3D） reconstruction images with rotational digital angiography technique in aorta lesions. Methods： Two-dimensional （2D） digital angiography, 3D recon- struction angiography and CT or MRI were performed in 31 male patients with aorta lesions with age ranging from 18 to 81 years （mean 56.5 years）. The images were analyzed retrospectively. Results： In all 31 cases of aorta lesions, there were 25 cases of aortic dissection fAD）,3 cases of aneurysm, 1 case of false aneurysm, 1 case of aortic arch malformation, 1 case of atheroma and aorta calcification. All cases of aortic dissection,aneurysm and false aneurysm were correctly diagnosed by an- giography and CT or MRI. The intimal laceration of aortic dissection was misdiagnosed by CT in 2 cases,but confirmed by 3D rotational angiography. One case of aortic arch malformation was misdiagnosed by CT as aneurysm, but correctly diag- nosed by 3D rotational angiography. Twenty-three cases of aortic dissection and 3 cases of aneurysms were treated by stent. Postoperative 2D digital angiography revealed that the results were satisfactory and no complications occurred. Conclusion： The technique of 3D reconstruction with rotational digital angiography is of great clinical value for the diagnosis and treat- ment of aorta lesions,and it can improve the safety and success rate of interventional treatment.

关 键 词：主动脉疾病 血管造影术 数字减影 磁共振血管造影术 图像处理 计算机辅助 放射学 介入性 

分 类 号：R445[医药卫生—影像医学与核医学]