肝动脉螺旋CT血管成像和三维重建的临床应用  

The Clinical Application of Hepatic Artery Spiral Computed Tomographic Angiography(SCTA) and Three-Dimensional Reconstruction(3D)

作　　者：罗建光[1] 杨东益[1] 刘固岗 杨树仁[1] 沈树斌[1] 李德泰[1] 伍玉枝[1] 

机构地区：[1]湖南医科大学附属第二医院放射科

出　　处：《实用放射学杂志》1999年第4期201-204,共4页Journal of Practical Radiology

摘　　要：目的：评价肝动脉螺旋ＣＴ血管成像（ＳＣＴＡ）和三维重建（３Ｄ）的临床价值，并比较ＳＣＴＡ两种３Ｄ成像方法（表面阴影显示和最大强度投影，简称ＳＳＤ和ＭＩＰ）对肝动脉的显示的差别。方法：对２２例患者的肝动脉进行了ＳＣＴＡ成像，８例与常规血管造影对照。结果：（１）ＳＣＴＡ三维重建可显示肝脏主要的和变异的供血动脉及副肝动脉，在良好地显示肝内病变动脉期血供特点的同时，还能显示病变的供血动脉和化疗栓塞后的肝动脉的变化。（２）ＳＳＤ可以良好地显示肝动脉分支和腹主动脉大分支处的复杂的解剖关系及变异。ＭＩＰ则对肝动脉肝段分支和病变的肝脏供血动脉等细小分支显示相对较好，更接近常规血管造影表现。ＭＩＰ对肝总动脉或肝固有动脉、第一、第二、第三级肝动脉分支的显示率分别为１００％、９５．５％、５０％和１８．２％，优于ＳＳＤ。３Ｄ对肝段以下细小动脉分支显示差。结论：ＳＣＴＡ可以较好地显示腹主动脉大分支和肝动脉较大分支处的复杂的解剖关系及变异，与常规血管造影相吻合，具有较高的临床价值。Objective:To assess the clinical utility of hepatic artery spiral computed tomographic angiography(SCTA)and threedimensional reconstruction(3D) techniques,and to compare the diagnostic value of the two 3 D techniques which include shaded surface display (SSD) and maximum intensity projection(MIP).Mathods:SCTA and 3D CT hepatic arteriograms were obtained in 22 cases,8 patients also underwent conventional angiography.Results:①SCTA and 3D images could clearly show the major and replaced or accessory arteries that supplied the liver and lesions during the phase of artery.They could also show the changings of the hepatic arteries after chemo-thrombolization therapy by the arteries.②SSD was better than MIP in showing bigger hepatic arterial branches,celiac branches and their complicated anatomic relationship and variations.But MIP could more satisfactorily show smaller hepatic arterial branches in liver and replaced arteries.MIP was coincided well with conventional angiography.The displaying rate of the common hepatic arteries and the first,the second,the third grade hepatic arterial branches were 100% 95.5%,50%,18.2% separetely on MIP.It was difficulty for SCTA and 3D to show the arteries which was smaller than segment arteries.Conclusion:3D CT arteriography is as accurate as angiography in the assessmnt of celiac and big hepatic arterial anatomy.It is also safer,more convenient and more easily tolerated.Hepatic arterial SCTA and 3D images have high clinical value.

关 键 词：肝动脉 血管成像 螺旋CT SCTA 三维重建 

分 类 号：R816.5[医药卫生—放射医学]