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目的 评价电子束CT(electronbeamcomputedtomography ,EBCT)血管造影及三维重建在主动脉瘤诊断中的临床应用价值。方法 收集经EBCT诊断的主动脉瘤 3 2例 ,男 2 4例 ,女 8例 ,其中 9例与手术结果作了对照。胸主动脉扫描采用单层步进容积增强扫描序列 (SVS ) ,心电门控采像 ;腹主动脉扫描采用单层连续容积增强扫描序列 (CVS ) ,无心电门控。所得图像进行后处理三维重建 ,主要采用多层面重组法 (MPR )、最大密度投影法 (MIP )、表面阴影显示法 (SSD )、容积再现法 (VR )进行处理。结果 3 2例主动脉瘤中 ,真性主动脉瘤 8例 ,假性动脉瘤 5例 ,夹层动脉瘤 19例。其中 9例动脉瘤接受手术治疗 ,手术证实EBCT诊断符合率为 10 0 %。结论 EBCT血管造影可获得高分辨率的大血管解剖影像 ,三维重建图像能直观地显示主动脉瘤病变的范围、大小形态及夹层动脉瘤内膜撕裂口 ,对诊断具有优良价值 ,并能指导手术。在主动脉瘤的诊断上 ,可取代常规血管造影。
Objective To evaluate the clinical value of electron beam computed tomography (EBCT) angiography and three-dimensional reconstruction in the diagnosis of aortic aneurysm. Methods 32 cases of aortic aneurysms diagnosed by EBCT were collected, including 24 males and 8 females, of whom 9 were compared with the surgical results. Thoracic aorta scanning using single-step incremental volume scan sequence (SVS), ECG gating; abdominal aortic scan using single continuous volume enhanced scan sequence (CVS), no gating. The resulting image is post-processed for three-dimensional reconstruction, which is mainly processed by multi-layer reconstruction (MPR), maximum density projection (MIP), surface shaded display (SSD) and volumetric rendering (VR). Results Of the 32 aortic aneurysms, 8 were true aortic aneurysms, 5 were pseudoaneurysms, and 19 were dissected aneurysms. Among them, 9 cases underwent surgical treatment of aneurysms. The coincidence rate of EBCT diagnosis was 100%. Conclusions EBCT angiography can obtain high-resolution macrovascular anatomy images. The three-dimensional reconstruction images can directly display the extent, size and shape of aortic aneurysms and the intimal tear of dissecting aneurysms, which is of great value in diagnosis and can guide surgery. In the diagnosis of aortic aneurysm, can replace routine angiography.