256层螺旋CT血管造影显示脊髓Adamkiewicz动脉的应用价值  

Application of 256-detector CT angiography in depicting Adamkiewicz artery

作　　者：王均干[1] 姜建威[1] 侯海燕[1] 常军[1] 殷允娟[1] 成岗[1] 

机构地区：[1]无锡市第三人民医院影像科,江苏无锡214041

出　　处：《实用放射学杂志》2012年第7期1102-1105,共4页Journal of Practical Radiology

摘　　要：目的评估256层CT血管造影显示脊髓Adamkiewicz动脉（AKA）的可行性。方法120例受试者接受256层CT血管成像，按照造影剂注射速率随机分成3组，4mL／s组、5mL／s组和6mL/s组，每组按照触发阈值200HU和350HU再分成2小组，每小组20例受试者。应用自动触发技术，达到阈值后延迟4S开始扫描，所有CTA均由256层CT扫描机扫描，造影剂使用2mL／kg．碘含量350mgl／mL，通过18G留置套管针肘前静脉注射，对原始数据进行容积重建（VR），多平面重建（MPR），最大密度投影（MIP）和曲面重建（CPR），由2位心血管影像诊断医师对结果进行分析。诊断标准：AKA在斜冠状位出现特征性的发夹征（hairpinsign），同时在血管CPR、MIP和VR显示AKA和主动脉之间的连续性确认。结果4mL／s200HU组确认7例，350HU组6例；5mL/sS200HU组确认11例,350HU组10例；6mL／s、200HU组确认19例，350HU组确认18例，3组间AKA确认率有明显的统计学差异（P〈0．01）。结论在6mL／s注射速率和200HU及350HU触发阈值扫描条件下，256层CT脊髓血管造影能够精确显示AKA和相应的节段性动脉。为临床提供可靠信息。Objective To evaluate the value of 256-detector CT angiography（CTA） in depicting Adamkiewicz artery （AKA） of spinal cord. Methods 120 patients without vascular diseases underwent 256-detector CTA. All cases were divided into three groups according to in iecting speed of contrast medium , 4 mL./s , 5 mL/s and 6 mL/s . Each group （ 20 cases）was again divided into to two groups according to ROI （200 HU and 350 HU）, scannings were started after reaching an ROI threshold at 4 s later. A total of 2 mL/kg of body weight of contrast material containing 350 mg of iodine per milliter was injected through 18-gauge plastic intrave- nous catheters which were placed at antecubital vein. Image data were transferred to a workstation. Volume reformation, muhiphmar reformation,maximum intensity projection and curved muhiplanar reformation images were analysed by two radiologists independ-ently. The AKAs were identified as an enhanced vessel oriented toward the anterior cord and joining the anterior spinal artery at the tip of a topical hairpin sign. Results The AKAs were identified in 7,6,11,10,19 and 18 patients in 4 mL/s,200 H U and 350 H U groups,5 mL/s,200 HU and 350 HU groups,6 mL/s,200 HU and 350 HU groups,respectively,there were statistically significant differences（P〈0.01） between them . Conclusion At an injection rate of 6 mL/s , after reaching an ROI threshold of 200 HU or 350 HU,256 detector CT angiography can depict Adamkiewicz artery accurately.

关 键 词：脊髓 血管造影 ADAMKIEWICZ动脉 体层摄影术 X线计算机 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学] R814.43[医药卫生—基础医学]