多层螺旋CT及后处理技术在颈部动脉受侵判断中的价值  

A study of arterial invasion in head and neck malignant tumors with multi-slice helical CT and its post-processing imaging techniques

作　　者：梁颖[1] 吴宁[2] 罗德红[2] 

机构地区：[1]首都医科大学红十字朝阳医院影像诊断科,北京100020 [2]中国医学科学院中国协和医科大学肿瘤医院影像诊断科,北京100021

出　　处：《放射学实践》2003年第11期783-786,共4页Radiologic Practice

摘　　要：目的 :评价多层螺旋CT横断面扫描像、MPR及VR技术对颈部动脉受侵判断的准确性 ,探讨后处理技术在颈部肿瘤侵犯颈部动脉方面的应用价值。方法 :使用 8层螺旋CT扫描机 ,对临床拟诊颈部动脉旁肿瘤的患者行前瞻性直接增强扫描 ,其中手术证实恶性肿瘤患者 40例 ( 4 8个肿物 )。两位医师对 40例手术患者的横断面扫描图像、MPR图像(包括AVE重组、MIP重组、CUR重组 )、VR图像中 5 3支颈部动脉是否受侵进行双盲法评价 ,对比手术及病理结果后给予评分 ,进行统计学分析。结果 :对颈部动脉 (包括颈动脉和锁骨下动脉 )受侵的判断 ,MPR的敏感性、特异性和准确性分别为 10 0 %、92 .1%和 94.3 %,敏感性较横断面提高了 6.7%(P =1.0 0 0 ) ,特异性与横断面相仿 (P =1.0 0 0 ) ,准确性与横断面相同 ( 94.3 %)。对动脉受侵的诊断价值 ,MPR和血管VR的应用价值达≥ 3分者分别占 71.7%和 14 .2 %(P =0 .0 0 0 ) ;MPR中 3种重组方法的价值相仿 (P =0 .817)。结论 :对动脉受侵的判断 ,MPR可为判断颈部动脉受侵提供重要的补充信息 ,增强诊断信心 。Objective:To assess the application of multi slice helical CT and its post processing imaging techniques including multiplanar reconstruction (MPR) and volume rendering (VR) in patients with head and neck malignant tumors with respect to the arterial invasion by tumors.Methods:In a prospective series,40 patients who underwent surgery with suspicion of head and neck malignant tumors were scanned using 8 slices helical CT scanner.48 masses were closely adjacent to the carotid artery or the subclavian artery.Fifty three arteries were analyzed with axial CT (ACT),MPR( AVE,MIP and CUR)and VR images correlated with surgical and pathological findings by two radiologists blindly.Results:In evaluation of the arterial involvement,the sensitivity,specificity and accuracy of MPR is 100%,92.1% and 94.3% respectively.MPR improved 6.7% in sensitivity with respect to the ACT ( P =1.000),but the specificity and the accuracy were similar to ACT( P =1.000). As to the MPR and VR in evaluation of arterial involvement,a score of ≥3 accounted for 71.7% and 14.2%( P =0.000),respectively.No statistical significance was noted with the three types of MPR in evaluating the arterial involvement ( P =0.817).Conclusion:In evaluation of the arterial involvement by head and neck neoplasms,MPR could provide helpful information in recognizing the neoplastic invasion of the arteries,however,the ACT still is the basic method .

关 键 词：多层螺旋CT 图像后处理技术 颈部动脉 颈部肿瘤 肿瘤侵袭 

分 类 号：R816.2[医药卫生—放射医学]