螺旋CT血管造影在颅底肿瘤中的应用价值  

Clinical application of spiral CT angiography in the skull base neoplasms

作　　者：左长京[1] 周晓平[2] 萧毅[1] 崔恒武[1] 吕桃珍[1] 王敏杰[1] 薛宏[1] 范月兰[1] 

机构地区：[1]第二军医大学长海医院放射科,上海200433 [2]长海医院神经外科

出　　处：《第二军医大学学报》2001年第6期592-594,F004,共4页Academic Journal of Second Military Medical University

基　　金：上海市医学发展基金重点研究课题(98ZD0 0 2 )

摘　　要：目的 :探讨颅底肿瘤螺旋 CT血管造影 (SCTA )的成像技术及其应用价值。 方法 :16例颅底肿瘤 ,MRI明确诊断后行 SCTA。 SCTA与 MRI、手术对照。螺旋扫描层厚 2 .0 m m,间距 1.0 mm ,螺距 1.0～ 1.2 5 ,均以 3.0 ml/s速度注射对比剂12 0 ml;用表面遮盖法 (SSD)重建三维图像 ,5例行伪彩 SSD重建及模拟手术入路。结果 :SCTA清楚显示了 14例颅底肿瘤的形态及其与大血管、颅骨的三维关系 ,而 1例颅咽管瘤、1例胶质瘤瘤体未显示 ,仅显示了受压移位的邻近血管及其与颅骨的关系。 SCTA的三维图像及模拟手术入路为治疗方案的制定提供了重要信息。结论 :SCTA提供的颅底肿瘤与邻近血管及颅骨关系的三维图像 ,是对常规二维影像的重要补充 。Objective: To research on the clinical value and techniques of spiral CT angiography (SCTA) in the examination of skull base neoplasms. Methods: Sixteen patients who had neoplasms near the skull base were examined with SCTA and MRI, and the findings of SCTA were compared with MRI and surgery.The thickness of spiral scanning was 2.0 mm, index 1.0 mm,pitch 1.0 1.25. We injected 120 ml contrast medium intravenously at a rate of 3.0 ml/s.The surface shaded display(SSD) technique was used to reconstruct the 3D images in every case and the color SSD images were used to imitate the neurosurgical approach in 5 patients. Results: SCTA clearly demonstrated the 3D shapes of the neoplasms and their relationship with adjacent vessels and the skull base.The bodies of a craniopharyngioma and a glioma were not shown in the SCTA images but the adjacent vessels pressed and the skull base were shown clearly. The 3D images of SCTA and simulated neurosurgical approach supplied important information to the therapy planning. Conclusion: SCTA can provide 3D images of the skull base neoplasms and clearly show their relationship with adjacent vessels and bones.They are important supplementary to conventional 2D images and have high directive value to therapy.

关 键 词：颅底肿瘤 X线计算机体层摄影术 螺旋CT 血管造影 SCTA 

分 类 号：R739.41[医药卫生—肿瘤] R730.44[医药卫生—临床医学]