64层螺旋CT血管成像在脊髓血管介入术前评估中的价值  

Value of 64-slice spiral computed tomography angiography in preoperative evaluation of spinal vascular intervention

作　　者：肖云华[1] 吕富荣[1] 吕发金[1] 孙向前[1] 彭冈力[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,400016

出　　处：《中华创伤杂志》2011年第2期157-160,共4页Chinese Journal of Trauma

基　　金：基金项目：重庆市卫生局资助项目（2008-2-108）

摘　　要：目的探讨64层螺旋CT在脊髓血管介入术前评估中的价值。方法选择17例胸腰段脊髓损伤患者行脊柱64层螺旋CT增强扫描，重建薄层图像，层厚0．625mm，间隔0．625mm，以DICOM格式传输到ADW4．2工作站，采用容积显示（volume rendering，VR）、最大密度投影（maximum intensity projection，MIP）及多平面重建（multi—planar reformat，MPR）等后处理技术进行三维重建，分析脊髓供血动脉的走行特征。结果17例患者中有16例患者（94％）胸腰段均可见根髓动脉供血脊髓，其中1支（6％）自T4/5，左侧椎间孔进入椎管，2支（12％）自T10/11。左侧椎间孔进入椎管，1支（6％）自T11/12左侧椎间孔进入椎管，4支（24％）根髓动脉自L1/2左侧椎间孔进入椎管，2支（12％）自L2/3左侧椎间孔进入椎管，2支（12％）自T11/12右侧椎间孔进入椎管，2支（12％）自T12／L3右侧椎间孔进入椎管，2支（12％）自L2/3，右侧椎间孔进入椎管，10例（59％）患者根髓动脉自左侧椎间孔进入椎管。另有1例（6％）患者行CT和DSA检查均未发现根髓动脉。结论64层螺旋CT能准确直观反映脊髓供血动脉的开口位置、走行方向、管径大小及其与周围血管的空间关系，为脊髓血管介入术前提供丰富的评估信息。Objective To investigate the value of 64-slice spiral computed tomography （CT） angiography in preoperative evaluation of spinal vascular intervention. Methods Seventeen patients with segmental injury of the spinal cord underwent the enhanced 64-slice CT scan of the spine. Thin-slice reconstruction was done, with the slice thickness of 0. 625 mm and interval of 0. 625 mm. The data were transferred to the work station ADW4.2 in DICM format. Image postprocessing technologies such as volume rendering （VR） , maximum intensity projection （MIP） and multi-planar reformat （MPR） were used to conduct three-dimensional reconstruction and analyze the anatomical characteristics of radiculomedul- lary artery. Results Radiculomedullary artery could be found in the thoracolumbar segment of 16 patients （ 16/17, 94% ）. Among them, one artery （ 1/17, 6% ） went into the vertebral canal through the left intervertebral foramen of T4/5 , two （2/17,12%） through the left intervertebral foramen of T10/11 , one （ 1/17, 6% ） through the left intervertebral foramen of TIH2, four （4/17, 24% ） through the left inter- vertebral foramen of L1/2, two （2/17, 12% ） through the left intervertebral foramen of L2/3, two （2/17, 12% ） through the right intervertebral foramen of T11/12, two （2/17, 12% ） through the right intervertebral foramen of TI2/L1 , two （2/17, 12% ） through the right foramen of L2/3 and10 （ 10/17, 59% ） through the left intervertebral foramen. Either CT scan or DSA examination found no radiculomed- ullary artery in one patient. All the above findings were in accordance with the results of DSA examination. Conclusions Spiral 64-slice CT scan can provide significant preoperative evaluation information for spinal vascular intervention, for it can accurately and visually show the anatomical features of the radiculomedullary artery such as open position, flow tendency, caliber size and spatial relationship with the surrounding vessels.

关 键 词：体层摄影术 X线计算机 放射造影术 介入性 血管 脊髓损伤 

分 类 号：R686[医药卫生—骨科学]