16层螺旋CT双期脑血管减影成像的可行性与临床应用  

Feasibility and clinical application of cerebral double phase subtraction angiography with 16-slice spiral CT

作　　者：毛俊[1,2] 王建明[1,2] 陈海东[1,2] 彭秀斌[1,2] 杜中立[1,2] 程光森[1,2] 许卫国[1,2] 林丽娟[1,2] 邓志峰[1,2] 

机构地区：[1]暨南大学附属珠海医院 [2]珠海市人民医院放射科,广东珠海519000

出　　处：《中国医学影像技术》2011年第10期2141-2145,共5页Chinese Journal of Medical Imaging Technology

基　　金：珠海市科技计划项目(PC20071066)

摘　　要：目的探讨16层螺旋CT脑动静脉双期减影去骨成像(DP-BSCTA)的临床应用价值。方法回顾性分析于我院行DP-BSCTA的117例患者病历资料。其中50例(A组,无血管病变)未行DSA检查;67例(B组)行DSA检查。按去骨程度、血管显示与污染程度分别对A组双期图像进行评分(1～5分),并计算后处理时间。用双盲法比较B组DP-BSCTA与DSA。统计两组辐射剂量。结果 A组:51个期相(51/100,51.00%)完全去骨(5分),其他辅以手工后完全去骨。软件双期去骨时间及辅以手工时间分别为(2.97±0.29)min、(2.22±0.96)min。45个(45/50,90.00%)动脉期及41个(41/50,82.00%)静脉期图像4～5分,37例(37/50,74.00%)双期评分均为4～5分。B组:阳性63例,其中动脉瘤29例,血管畸形11例,烟雾病3例,静脉窦血栓3例,动脉狭窄病变17例(34处);阴性4例。DP-BSCTA检出脑血管病变的敏感度和特异度均为100%。两组剂量长度乘积平均(875.77±67.94)mGy.cm。结论 16层螺旋CT DP-BSCTA能快速去除颅骨,同时得到类似DSA的动、静脉期高质量图像,检出脑血管病变的能力与DSA相当,值得临床推广。Objective To investigate the application value of double phase bone removal subtraction cerebral angiography（DP-BSCTA） using 16-slice spiral CT.Methods Totally 117 patients who underwent DP-BSCTA were divided into group A（n=50,without cerebrovascular disease,did not undergo DSA）,and group B（n=67,with cerebrovascular diseases,underwent DSA）.The bone structures were removed with Neuro DSA software.In group A,the postprocessing time was counted.The subtraction images of double phase were scored（1—5） according to various degrees of the residual bones,as well as the vessel displayed and contaminated,respectively.In group B,the difference of diagnosis between DP-BSCTA and DSA was compared.The average radiation dose of DP-BSCTA was calculated in two groups.Results Of group A,the bones were completely removed in 51（51/100,51.00%） phase images（5 points）.All residual bones and artificial images of the rest phase images were removed by hand-made.The handling time with Neuro DSA software and with hand-made was（2.97±0.29）min and（2.22±0.96）min,respectively.There were 45（45/50,90.00%） arterial phase and 41（41/50,82.00%） venous phase images scored 4—5.The images of double phase were 4—5 points in 37 cases（37/50,74.00%）.Of group B,63 cases were positive in DP-BSCTA（29 cases of aneurysms,11 vascular malformation,3 Moya-moya disease,3 sinus venosus thrombus and 17 cases of arteriostenosis）,4 cases were negative.Compared with DSA,the sensibility and specificity of DP-BSCTA was all 100% in diagnosing cerebrovascular disease.The mean dose length product of the two groups was（875.77±67.94）mGy·cm.Conclusion With bone structures rapidly removed,the images of DP-BSCTA in 16-slice CT are approximately similar to DSA.The diagnostic capability of DP-BSCTA for cerebrovascular disease is equal to that of DSA.

关 键 词：脑血管造影术 血管造影术 数字减影 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学]