CT后处理技术显示主动脉夹层破口的比较研究  

Comparative Study of CT Post-Processing Techniques in Displaying Aortic Dissection

作　　者：肖东健 林玉琳[2] 岳鑫[1] 刘丹妮 王素丽 郭鹭鑫 蔡小萍 康江河[1] XIAO Dong-jian;LIN Yu-lin;YUE Xin;LIU Dan-ni;WANG Su-li;GUO Lu-xin;CAI Xiao-ping;KANG Jiang-he(Department of Imaging,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004 Fujian Province,China;Magnetic Resonance Department,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004,Fujian Province,China)

机构地区：[1]厦门大学附属中山医院影像科,福建厦门361004 [2]厦门大学附属中山医院磁共振室,福建厦门361004

出　　处：《中国CT和MRI杂志》2023年第2期82-84,共3页Chinese Journal of CT and MRI

基　　金：厦门市科技计划项目(3502Z20189037)。

摘　　要：目的 研究CT扫描不同图像后处理技术对主动脉夹层破口检出率的影响。方法 选取106例以突发性胸痛为主诉的主动脉夹层患者行多层螺旋CT血管成像检查,采用最大密度投影(MIP)、容积重建(VR)、多平面重建(MPR)、曲面重建(CPR)、表面遮盖成像(SSD)等技术进行图像后处理。结果 原始横轴位图像的夹层动脉瘤破口检出率为37.7%,MIP、CPR、MPR、VR、SSD的夹层破口检出率分别为0.0%、46.2%、69.8%、65.1%、39.6%。最终97例能明确显示夹层破口,夹层破口的检出率为91.5%,9例因破口直径太小、升主动脉根部伪影或假腔完全血栓化等原因而显示欠佳。MPR、CPR、VR对夹层破口的总检出率明显高于SSD与MIP(P<0.01)。MPR、VR对Ⅰ型、Ⅱ型的检出准确率相对较优,而CPR、MPR对Ⅲ型的检出准确率也呈现出相对更佳的综合特点。结论 CT扫描结合图像后处理技术呈现出较为明显的相对优势,不同图像后处理技术各有优缺点,其中MPR操作简单、对夹层破口的显示能力强及准确分型,可作为首选。Objective To study different post-processing techniques for CT scanning on the detection rate of aortic dissecting aneurysm. Methods From 106 patients with aortic dissection with sudden chest pain as the main complaint were selected for multi-slice spiral CT angiography,maximum intenstity projection(MI P),volumerendering(VR),multiplanar reconstruction(MPR),curved planar reconstruction(CPR),Surface cover imaging(SSD)were used for image post-processing. Results The fracture detection rate of original horizontal axis images was 37.7%,and MIP,CPR,MPR,VR and SSD was respectively 0,46.2%,69.8%,65.1%and 39.6%.Finally,97 cases could clearly show the break,and the detection rate of the break was 91.5%,while 9 patients showed poor results due to the size of the rupture,aortic pulsation artifacts,or complete thrombosis of the pseudocavity.The detection rate of MPR,CPR and VR for fracture were significantly higher than that of SSD and MIP,and the comparison were statistically significant(P<0.05).The detection accuracy of MPR and VR for type Ⅰ and Ⅱ was relatively better,while the detection accuracy of CPR and MPR for type Ⅲ was also relatively better. Conclusion CT scanning combined with image post-processing technology shows significant advantages and disadvantages. Different image post-processing technologies have different advantages and disadvantages. Among them,MPR can be used as the first choice for clinical diagnosis due to its strong display ability and accurate classification of interlayer fractures,and its simple operation.

关 键 词：主动脉夹层破口 图像后处理技术 体层摄影术 X线计算机 

分 类 号：R543.1[医药卫生—心血管疾病]