三维动态增强磁共振腹部血管造影

目的:探讨三维动态增强磁共振腹部血管造影(3D-CE-MRA)成像技术和临床应用意义。方法:回顾性的分析了30例腹部3D-CE-MRA的成像技术和MRI表现。结果:全部病例显示良好,可以从不同的角度和位置上观察血管的整体形态。结论:三维动态增强磁共振腹部血管造影是诊断腹部血管病变首选的影像学检查方法,具有较高的临床应用价值。     

4D-CTA影像分析脑动静脉畸形血管构建特征与临床出血价值探讨

目的 通过320排CT动态容积4D-CTA成像技术分析脑动静脉畸形(cAVM)血管构建与脑出血风险的相关性.方法 对97例cAVM病例资料进行回顾性分析,通过4D-CTA影像图像研究cAVM的供血动脉、引流静脉、畸形血管团等不同血管构建因素进行分析,判断不同血管构建的cAVM患者出血比率的相关性.结果 本组97例患者中,脑出血66例,出血率68％.cAVM供血动脉数目、畸形血管团大小与出血率差异均无统计学意义(均P＞ 0.05);cAVM引流静脉(数目、是否狭窄、引流部位)、cAVM畸形血管团部位及cAVM是否伴发动脉瘤与出血率差异均有统计学意义(均P＜ 0.05).结论 4D-CTA动态容积成像技术能够清楚显示cAVM血管构建特征,对判断cAVM出血具有重要的临床价值.     

三维动态增强MR血管造影在颈动脉海绵窦瘘诊断价值

目的探讨三维动态增强MR血管造影(3D-CE-MRA)在颈动脉海绵窦瘘(CCF)的诊断价值。方法回顾性分析10例具有完整临床和影像学资料的CCF病例,所有患者均行三维时间飞跃法MR血管造影(3DTOF-MRA)及3D-CE-MRA,其中7例为外伤性,3例为自发性,男性6例,女性4例,均经临床及DSA确诊,比较分析3D-TOFMRA与3D-CE-MRA在CCF的显示效果。结果10例患者中3D-TOF-MRA可见6例显示海绵窦扩张,9例可见眼上静脉扩张,2例岩上窦、2例岩下窦引流,海绵间窦扩张2例,瘘口显示2例;3D-CE-MRA可见全部10例患侧海绵窦扩大,3例为两侧海绵窦显影并扩大,可见海绵间窦扩张,眼上静脉扩张10例,岩上窦引流5例,岩下窦7例,瘘口显示6例。结论 3D-CE-MRA较3D-TOF-MRA在CCF诊断对海绵窦扩大及瘘口显示、静脉回流等细节显示更清楚,但对双侧海绵窦同时显影时需结合临床及其他征象鉴别。     

三维动态增强MR血管造影在门静脉高压评价及治疗中的应用

目的:探讨三维动态增强磁共振血管造影(3D-CE-MRA)在门静脉高压的影像表现特征和临床应用价值.方法:20例门静脉高压患者行3D-CE-MRA检查加中上腹部平扫及工作站三维重建.结果:门静脉高压3D-CE-MRA主要表现为:正常门静脉形态消失,肝内二级以上门静脉不显影,呈"枯树枝"状改变,局部代之以大量扭曲的侧枝血管,腹腔及腹壁可见侧枝血管.结论:3D-CE-MRA能完整显示门静脉系统及侧枝循环情况,对临床评价及治疗门静脉高压有重要价值.     

三维螺旋CT血管重建诊断子宫动静脉瘘

目的 探讨三维螺旋CT血管重建(3D-CTA)在子宫动静脉瘘中的价值.方法 选取1例子宫动静脉瘘患者64排螺旋CT数据,采用三维重建技术进行血管三维重建.结果 3D-CTA可以清晰显示骨盆、髂总动脉、髂外动脉及其分支、髂内动脉、子宫动脉及畸形血管团的位置、大小、供血动脉和引流静脉的立体空间关系.结论 3D-CTA能准确诊断子宫动静脉瘘,为临床诊治提供清晰立体的影像资料.     

全下肢磁共振血管造影

<正> 随着磁共振血管造影的发展,显示血管图像的非创性检查方法已越来越多,如2D、3DTOF法PC法,目前头颈部磁共振血管成像大多采用时间飞跃法(TOF),虽然能够解决许多问题,但仍然存在着诸多缺点,如采集时间、预饱和静脉血流信号困难、伪影和假象等,其空间分辨率及图像信噪比也不尽人意。而移床法三维动态增强磁共振血管造影(3D-CEMRA)是采用快速扫描序列连续追踪向下流动的造影剂团,可以大大改变周围血管病变成像质量,并且可以同时更准确地显示整个腹、盆腔及下肢血管树,明显优于TOF法,我院已利用此法完成20     

三维CT血管造影在颅内动脉瘤介入栓塞治疗中的应用

为评价三维CT血管造影(3D-CTA)在颅内动脉瘤栓塞治疗中的指导意义及其局限性,收集我院2006年1月—2008年6月收治的68例颅内动脉瘤患者,所有患者均进行数字减影脑血管造影(DSA)检查。3D-CTA图像重建时分别采用表面阴影显示法(SSD)、最大强度投影法(MIP)、体积透视图法(VR)以及仿真血管内镜技术法(VRT)分别重建颅内血管三维图像。DSA常规进行双侧颈内动脉及左侧椎动脉造影,必要时进行右侧椎动脉造影。结果本组68例患者,DSA检查和3D-CTA检查各发现动脉瘤76个,3D-CTA的诊断准确率为100%。动脉瘤最大直径平均(4.7±3.0)mm;3D-CTA检查MIP法测为(4.8±3.0)mm,SSD法检测为(5.0±3.0)mm。三者间所测得的动脉瘤最大直径的差异均无统计学意义(P>0.05)。3D-CTA能够避免常规DSA检查时产生的影像重叠,但是三维重建后的影像受到多种因素的影响,制定合理的检查方案可有效提高诊断符合率,对动脉瘤的栓塞治疗提供很大的帮助。     

16层螺旋CT三维血管造影在颅内动脉瘤中的诊断及临床应用价值

目的 探讨三维CT血管造影(three dimensional computed tomographic angiography,3D-CTA)在颅内动脉瘤的临床应用及其价值.方法 对自发性蛛网膜下腔出血及怀疑颅内血管瘤的病例共53例患者,行3D-CTA检查(时间在发病后4 h到3 d).并行数字减影血管造影(digital subtraction angiography,DSA)检查.结果 经3D-CTA、DSA和手术共同证实发现44例共49个动脉瘤.在44例动脉瘤患者中,3D-CTA发现42例47个动脉瘤.DSA发现43例48个动脉瘤.动脉瘤的瘤体最大径及瘤颈最大径3D-CTA测量值与DSA测量值比较差异无统计学意义(t=0.59和t=0.49,均为P>0.05).表明3D-CTA所显示颅内动脉瘤位置、大小、数量等结果与DSA检查基本相符.53例病情轻重不一患者在行3D-CTA检查过程中,病情无加重或无其他意外发生.结论 3D-CTA对颅内动脉瘤诊断准确率高,可精确显示动脉瘤的三维空间形态率,与DSA检查互补可得到颅内动脉瘤更完整的信息其有快捷、经济、安全和微创等优点.     

三维CT血管造影与三维数字减影血管造影测量颅内破裂动脉瘤形态学参数的对比评价

目的 对比三维CT血管造影(3D-CTA)与三维数字减影血管造影(3D-DSA)测量评价颅内破裂动脉瘤形态学参数是否存在差异性。方法 行CTA与DSA检查的37个颅内破裂动脉瘤,按照瘤体最大径分组,利用3D-CTA与3D-DSA技术对比测量瘤体最大径(Hmax)、瘤体高度(H)、瘤径(D)、长宽比(AR)、大小比值(SR)、动脉瘤倾斜角度(AA)。结果 7 mm动脉瘤,Hmax、H、D测量差异无统计学意义(P0.05);而≤7 mm的动脉瘤,Hmax、H和D的CTA测量数值略大于DSA,比较差异有统计学意义(P0.05);无论动脉瘤大小,AR、SR和AA差异无统计学意义(P0.05)。结论 3D-CTA测量≤7 mm的动脉瘤与3D-DSA存在一定差异,临床实践中应注意。     

磁共振对比剂增强血管造影在颈部血管的应用

对 4 8例临床怀疑椎基底动脉供血不足病例行常规 2 D- TOF和 3D- CEMRA成像检查。 2 D- TOF和 3D-CEMRA图像均能较好地显示与采集层面垂直的颈内、外动脉及椎管内段椎动脉。对与层面平行的椎动脉入颅段及基底动脉环的显示 3D- CEMRA比 2 D- TOF好。 3D- CEMRA显示血管狭窄较 2 D- TOF敏感和准确     

Three-dimensional CT angiography and surgical correlation in the evaluation o f intracranial aneurysms

目的：评价三维CT血管成像（3D-CTA）在外科治疗颅内动脉瘤中的诊断效能。方法：24例可疑动脉瘤患行常规脑血管造影、3D-CTA、MRA和DSA检查。结果：本组共发现28个动脉瘤。21例病人仅有一个,2例有两个,1例有三个动脉瘤。3D-CTA发现瘤体呈球形为20个、椭圆形5个、分叶形3个。手术暴露的24个动脉瘤,其瘤体形态与3D-CTA发现完全吻合。动脉瘤颈平均直径为5.9mm,最小为1.6mm,最大为13.7mm。根据3D-CTA计算的动脉瘤颈结果与手术发现非常接近。3D-CTA对载瘤动脉和分枝动脉的形态描述明显优于常规脑血管造影 、MRA和DSA。结论：3D-CTA在了解动脉瘤的三维结构和制定手术治疗方案有重要辅助作用。     

Significance of the preoperative guidance of dual-source CT in carotid body tumor

Background Accurate views of the head and neck vessels, tumor angiogenesis and the relationship of tumor and the surrounding blood vessels are especially crucial to carotid body tumor （CBT） patients. The aim of this study was to explore the value of dual-source CT （DSCT） cerebral and carotid angiography in CBT diagnosis.Methods DSCT cerebral and carotid angiography was performed on nine patients with CBT. Two-dimensional and three-dimensional reconstruction images were obtained by means of multiple planar reconstructions （MPR）,maximum intensity projection （MIP） and volume rendering （VR）. All patients were subjected to color Doppler flow imaging （CDFI） examination. Two kinds of examinations were performed in 3 days, and all patients were confirmed by surgery.Results DSCT angiography was successful in all patients. CBTs were diagnosed in 9 patients with 10 lesions （1 case had multiple bilateral CBTs）. The largest lesion was 12 cm in diameter, and the smallest one was 1.6 cm in diameter. All patients had clearly demonstrated head and neck vessels, tumor angiogenesis, and tumor relationship with the surrounding blood vessels. The internal and external carotid artery （ICA, ECA） were involved in 2 cases. There were 7 cases with basilar artery ring integrity, and 1 case had the posterior communicating artery absent; 1 case had middle cerebral artery stenosis; 4 cases （4 tumors） showed arterial phase homogeneous enhancement; 5 cases （6 tumors） had obvious heterogeneous enhancement where irregular low-density necrosis could be seen in the tumors. CDFI could demonstrate the nearby blood vessels and tumor structure, instead of tumor angiogenesis. However, DSCT can display both the tumor and the peripheral vascular tumor angiogenesis consistent with surgical findings.Conclusions DSCT cerebral and carotid angiography can provide reliable information for the operation. It might be a valuable CBT diagnostic method by showing accurate views of the CBT along with the bilateral neck and brain blood vessels.     

应用容积重建成像三维CT血管造影方法诊断颅内动脉瘤

目的研究CT血管造影(CTA)及容积重建技术(VR)对颅内动脉瘤的临床应用价值。方法采用Siemens Plus 4 Somatom Volume Zoom型容积CT扫描机获得原始图像,采用容积重建成像技术(VR)进行三维重建,并辅助运用多轴面重建(MPR),共对45例动脉瘤患者进行了CTA检查,其中有25例同时行数字减影血管造影(DSA)检查,2l例行动脉瘤夹闭术治疗,3例行GDC栓塞术,其余保守治疗。结果共诊断45例动脉瘤患者,发现动脉瘤59个,其中小动脉瘤(≤5mm)32个。容积重建成像CTA清晰显示颅内动脉瘤、载瘤动脉、动脉瘤的形状和大小及其与邻近结构的解剖关系,在部分病例上要优于DSA。结论容积重建成像CTA是一种可靠、无创的快速诊断颅内动脉瘤的方法,为手术提供了详实的影像学资料,可帮助制定治疗方案：     

双源 CT 血管成像在颈动脉体瘤术前评估中的价值

目的：探讨双源CT （DSCT ）血管成像在颈动脉体瘤术前评估中的价值。方法收集18例颈动脉体瘤患者行DSCT头颈部血管造影,通过多方位重建（MPR）、最大密度投影（MIP）和容积再现（VR）得到二维和三维重建图像。所有患者均同时做了彩色多普勒血管显像（CDFI）检查,并均经手术证实。结果 DSCT血管成像均能成功地检查所有患者,18例患者共检出18个颈动脉体瘤,所有患者均为单侧颈动脉体瘤,肿瘤直径最大为12 cm ,最小为1.2 cm ,所有患者的头颈血管、肿瘤的血管生成以及肿瘤与周围血管的关系均得以清楚显示。结论 DSC T血管成像是一种很有价值的可以准确显示颈动脉体瘤患者双侧的头颈血管的诊断手段,能为手术提供可靠的信息。     

Three-dimensional CT angiography study on the relations between the vertebral artery and atlantoaxial joint

Background The vertebral artery （VA） and atlantoaxial joint （AAJ）, with complicated structures, are located in the depths of the head-neck boundary area, the regional anatomy of which cannot be shown globally and directly. This study aims to evaluate three-dimensional CT angiography （3DCTA） in displaying the AAJ, atlantoaxial segment of the vertebral artery （ASVA） and the identification of their interrelations. Methods Sixty-eight subjects without pathology of the ASVA and AAJ were selected from head-neck CTA examination. All the 3D images were formed with volume rendering （VR） together with techniques of separating, fusing, opacifying and false-coloring （SFOF）. On the 3D images, the ASVA and AAJ were observed, and their interrelations were measured. Results All the 3DCTA images were of high quality and up to our requirements. They could clearly and directly show the ASVA, ascending along the AAJ. There were 5 curves in the course of the ASVA, of which 2 curves were away from the atlantoaxial joint, one in the 2rid curve of 0.0 mm-5.4 mm, the other in the 4th of 2.6 mm-9.2 mm. There was no significant difference in the measurements between left and right （P 〉0.05）. The curved parts of the ASVA slightly expanded, with the biggest diameter of 5.6 mm in the 4th curve. Statistical comparison shows that the left ASVA is larger than the right （P 〈0.05）. Variations of the ASVA were found in 8 cases and of the AAJ in 12. Conclusions 3DCTA can globally and directly demonstrate the structures of the AAJ, ASVA and their interrelations. The 3D imaging data make up and enrich the research contents of regional anatomy and lay the foundation for related study and applications.     

Combined application of virtual imaging techniques and three-dimensional computed tomographic angiography in diagnosing intracranial aneurysms

Background The diagnostic value of virtual imaging combined with three-dimensional computed tomographic angiography （3D-CTA） for intracranial aneurysms has not been fully elucidated yet. This study aimed to evaluate the value of combined application of virtual imaging techniques and 3D-CTA in diagnosing patients with aneurismal subarachnoid hemorrhage （SAH） at the acute stage. Methods Eighty patients with non-traumatic SAH received 3D-CTA examinations. The raw CT data of these patients were reconstructed and transferred into the 3D mode through the surgical plan system based on virtual reality （VR） image, and the 3D virtual images of skulls and brain blood vessels were acquired. The location, size and shape of aneurysms and their anatomic relationship with adjacent tissues were measured from many points of view. Results Seventy-three aneurysms were detected in 68 of the 80 patients, but 2 aneurysms were detected in 2 of the 5 patients who had been found free of aneurysms previously and had received 3D-CTA examinations for a second time one month later. The 3D virtual images produced by the virtual imaging system were clear and vivid, and they could reveal the location and size of the aneurysm and its relations to the parent artery and skull directly. Conclusions The imaging of 3D-CTA is convenient, reliable and fast in diagnosing intracranial aneurysms and can be regarded as the first choice for the diagnosis and treatment of ruptured intracranial aneurysms. Combined with the surgical plan system based on the VR image, 3D-CTA may obtain more imaging information about aneurysms.     

单倍剂量三维对比增强MRA在肢体软组织血管瘤诊断中的应用价值

目的探讨单倍剂量三维对比增强MRA（3D-CE-MRA）在肢体软组织血管瘤诊断中的应用价值。方法回顾性分析13例经手术病理证实的肢体软组织血管瘤的MRI表现,全部病例均先行MRI平扫,接着进行单倍剂量三维对比增强MRA检查（包括动脉早期、动脉晚期、静脉期）,最后行常规增强扫描。结果血管瘤3D-CE-MRA表现：全部肿瘤均能显示供血动脉及引流静脉,从动脉期至静脉期瘤体内出现迂曲的、由近端向远端逐渐变细的血管团,肿瘤逐渐强化、显影范围增大。结论单倍剂量3D-CE-MRA诊断肢体软组织血管瘤具有特征性表现,并能显示与周围血管的关系。     

Mn3[Co (CN)6]2@SiO2对鼠C6脑胶质瘤模型3T MR成像及生长规律的研究

目的 利用Mn3[Co(CN)6]2@SiO2对大鼠C6脑胶质瘤模型进行3T MR成像,研究肿瘤的生长规律.方法 收集对数生长期鼠C6胶质瘤细胞,建立鼠C6脑胶质瘤模型,于细胞接种后第7 d行MR扫描,然后鼠尾静脉注射0.5 mL Mn3[Co(CN)6]2@SiO2,于注射后5 min、24 h再行MR扫描,扫描结束后取出肿瘤组织行HE染色.随机抽取脑内成功接种C6胶质瘤细胞的荷瘤鼠10只,接种后第7、9、11、13、15、17、19天行MR扫描,测量肿瘤体积,绘制出肿瘤生长曲线.结果 成功建立了鼠C6脑胶质瘤模型,并且鼠尾静脉注射Mn3[Co(CN)6]2@SiO2后5 min、24 h肿瘤均强化,24 h肿瘤强化较前明显;MRI检测出胶质瘤大小与时间呈正相关关系(rs=0.9944,P=0.000).结论 应用Mn3[Co(CN)6]2@SiO2对鼠C6脑胶质瘤活体示踪MR成像,可以反映肿瘤的生物学特性,适用于肿瘤生长规律的观测.     

双源CT容积脑灌注在急性脑梗死诊断中的应用价值

目的  探讨双源CT容积脑灌注成像（VPCT）在急性脑梗死的诊断价值。方法  对27例临床拟诊为急性脑梗死患者,于发病4～72h内行颅脑CT平扫和VPCT,获得三维VPCT参数图：脑血流量（CBF）、脑血容量（CBV）、排空时间（TTD）及平均通过时间（MTT）,并重建颅脑4D-CTA;于VPCT检查后48 h内复查MRI DWI,分析VPCT、4D-CTA及MRI DWI表现。结果  27例患者VPCT发现与临床症状相对应低灌注区70处,MR DWI表现为梗死灶53处;14处梗死灶4D-CTA显示相应责任血管病变。结论  双源CT容积脑灌注可同时获得VPCT和4D-CTA图像,为急性脑梗死临床治疗、预后评估提供参考。

     

兔VX2肝癌模型制备的改进及其磁共振影像学表现

目的 改进兔VX2肝癌模型的制作方法。使之更为简便、省时，同时探讨瘤灶的MRI表现及MRI在动态检测瘤灶中的作用。方法 新西兰大白兔16只，随机分成4组（每组4只），在螺旋CT引导下，采用瘤块组织接种于兔肝脏左、右叶，接种后14、18、22、26d分别行MRI平扫、增强扫描及病理分析。结果 16只实验兔发现瘤灶，成瘤率100％；瘤灶以种植后18～22d MRI显示最清楚和典型，直径1～2cm，平扫呈低或等信号．增强扫描瘤灶边缘明显强化．种植后超过22d的肿瘤中央坏死明显。结论 螺旋CT引导下进行兔VX2肝癌模型的制作，使制作过程更为简便、省时；采用磁共振平扫及增强扫描对瘤灶进行动态检测、评价，可更为准确、及时地观察瘤灶的发生、发展等影像学改变。