CT血管成像在大动脉炎诊断中的价值  

The value of CT angiography in the diagnosis of Takayasu's arteritis

作　　者：徐彦东[1] 张凤翔[1] 张浩亮[1] 刘智君[1] 杜海[1] 奇丽霞 贾艳荣[1] 郝艳霞[2] XU Yandong;ZHANG Fengxiang;ZHANG Haoliang;LIU Zhijun;DU Hai;QI Lixia;JIA Yanrong;HAO Yanxia(CT-MRI Room,Ordos Central Hospital,Ordos,Immer Mongolia 017000,China;Department of Rheumatology,Ordos Central Hospital,Ordos,Immer Mongolia 017000,China)

机构地区：[1]鄂尔多斯市中心医院CT-MRI室,内蒙古鄂尔多斯017000 [2]鄂尔多斯市中心医院风湿免疫科,内蒙古鄂尔多斯017000

出　　处：《实用放射学杂志》2020年第12期1944-1947,1956,共5页Journal of Practical Radiology

摘　　要：目的探讨CTA对大动脉炎(TA)的诊断价值.方法回顾性分析24例确诊为TA的临床及CT资料,所有病例图像经CPR、MPR、MIP和VR分析,实验室检查包含红细胞沉降率(ESR)和C反应蛋白(CRP).结果按Lupi-Herrea分型,其中Ⅰ型5例,Ⅱ型3例,Ⅲ型15例,Ⅳ型1例.小动脉活动期厚度为(3.54±1.79)mm、非活动期厚度为(1.98±1.08)mm,大动脉活动期厚度为(8.51±0.96)mm、非活动期厚度为(6.58±0.88)mm;小动脉活动期平扫CT值(54.11±10.8)HU、非活动期平扫CT值(45.36±8.2)HU,活动期增强后CT值为(72.79±10.8)HU、非活动期增强后CT值为(66.54±8.91)HU;活动期ESR为44.29±26.45、非活动期ESR为9.67±5.64;活动期CRP为21.46±8.5、非活动期CRP为6.63±2.52.结论CTA可以全面展显示受累血管的范围、管壁增厚、管腔狭窄或闭塞、侧支血管及少见并发症,在TA的分型、分期和疗效评价方面具有较高价值,是TA首选的影像学检查方法.Abstract:Objective To investigate the diagnostic value of CTA in Takayasu's arteritis(TA).Methods The clinical and CT data of 24 cases with TA were analyzed retrospectively.All cases were reconstructed by surface CPR,MPR,MIP and VR analysis.Laboratory tests included erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP).Results According to Lupi Herrea classification,5 cases were typeⅠ,3 cases typeⅡ,15 cases typeⅢ,and 1 case was typeⅣ.The thickness of the arteriole was(3.54±1.79)mm in the active period,and(1.98±1.08)mm in the inactive period respectively.The thickness of the large artery was(8.51±0.96)mm in the active period,and(6.58±0.88)mm in the inactive period respectively.The mean CT value of the arteriole was(54.11±10.8)HU in the active period and(45.36±8.2)HU in the inactive period respectively.After enhanced study,the CT value was(72.79±10.8)HU in the active period and(66.54±8.91)HU in the inactive period respectively.The ESR was 44.29±26.45 in the active period,and 9.67±5.64 the inactive period respectively.The CRP was 21.46±8.5 in the active period and 6.63±2.52 in the inactive period.Conclusion CTA can fully display the extent of the affected vessels,thickened wall of the affected vessels,stenosis or occlusion of the lumen,collateral vessels and rare complications.It has high value in the classification,staging and evaluation of aortic inflammation,which is the first choice of imaging examination for TA.

关 键 词：大动脉炎 计算机体层成像 血管造影术 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.5[医药卫生—放射医学]