128层螺旋CT血管成像及后处理技术诊断主动脉夹层价值  

Value of 128-slice spiral CT angiography and post-processing technique to the diagnosis of aortic dissection

作　　者：高才良[1] 乐暾 曾文兵[1] 管川江 杨染[1] 汪明全[1] 

机构地区：[1]重庆三峡中心医院放射科,重庆万州404000 [2]川北医学院,四川南充637000

出　　处：《中华实用诊断与治疗杂志》2016年第9期914-916,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：重庆市卫计委课题(2008-2-391)

摘　　要：目的探讨128层螺旋CT血管成像及后处理技术在主动脉夹层(aortic dissection,AD)诊断中的价值。方法疑诊AD患者78例,均行128层螺旋CT血管成像检查,进行容积再现技术(volume rendering technique,VRT)、自由切割成像、多平面重组(multiplanar reformation,MPR)、曲面重建(curved planar reformation,CPR)及最大密度投影(maximum intensity projection,MIP)等后处理。对AD患者行Stanford分型和DeBakey分型,比较动静脉期AD真假腔CT值,及后处理技术对AD内膜破口的显示率。结果 128层螺旋CT血管成像检出AD患者59例,Stanford分型A型21例、B型38例,DeBakey分型Ⅰ型13例、Ⅱ型8例、Ⅲ型38例;动脉期时AD真腔CT值[(257.37±51.79)Hu]高于假腔[(225.76±50.26)Hu],静脉期时AD真腔CT值[(157.39±59.56)Hu]低于假腔[(164.54±57.35)Hu],差异均有统计学意义(P<0.05);自由切割成像+轴位对内膜初始破口的显示率为93.22%、自由切割成像为89.83%、CPR为83.05%、MPR为81.36%、轴位为76.27%,明显高于VRT(35.59%)和MIP(13.56%),差异有统计学意义(P<0.05)。结论 128层螺旋CT血管成像是术前诊断AD及对AD作出准确分型的可靠影像学检查方法,但其不同后处理技术各有优缺点,对内膜初始破口的显示率不同。Objective To investigate the value of 128-slice spiral CT angiography and post-processing techniques to the diagnosis of aortic dissection （AD）. Methods Seventy-eight patients with suspected AD underwent 128-slice spiral CT angiography examination and post-processing reconstruction including volume rendering technique （VRT）, free cutting imaging, multiplanar reformation （MPR）, curved planar reformation （CPR）, maximum intensity projection （MIP）. All patients received Stanford typing and DeBakey typing. The arteriovenous CT values of true and false lumen level and the displaying rate for AD intimai tear by post-processing technique were compared. Results 128-slice spiral CT angiography detected AD in 59 cases, including 21 cases of Stanford type A, 38 cases of Stanford type B, 13 cases of DeBakey type Ⅰ , 8 cases of DeBakey typeⅡ , and 38 cases of DeBakey type Ⅲ. The average CT value of the true lumen （（257.37± 51.79） Hu） was significantly higher than that of false lumen （（225. 76 ± 50. 26） Hu） in arterial phase, and was significantly lower （（157.39±59.56） Hu） than that of false lumen （（164.54±57.35） Hu） in venous phase （P〈0.05）. The displaying rate for the intimal tear of free cutting imaging plus axial view was 93.22%, of free cutting imaging was 89.83%, of CPR was 83.05%, of MPR was 81.36%, and of axial view was 76.27%, significantly higher than that of VRT （35.59%） and of MIP （13.56%） （P%0.05）. Conclusion 128-slice spiral CT angiography is a reliable imaging method for preoperative diagnosis and accurate typing of AD. Since each post-processing technique has its own advantages and disadvantages, the displaying rate for intimal tear is different.

关 键 词：主动脉夹层 多层螺旋CT血管成像 后处理技术 

分 类 号：R816.2[医药卫生—放射医学] R543.1[医药卫生—临床医学]