256排螺旋CT对主动脉瘤及主动脉夹层的临床应用

目的：评价256排螺旋CT对主动脉瘤及主动脉夹层术前术后诊断评估的价值;针对主动脉瘤及主动脉夹层腔内修复术后的患者,探讨在保持CTA诊断内漏效能的同时,减少患者接受放射剂量。方法：在我院诊断并治疗患者60例,256层螺旋CT对主动脉瘤及主动脉夹层术前的影像分析;主动脉瘤及主动脉夹层术后256层螺旋CT检查技术研究,对内漏动脉期与静脉期图像比较,分析两者的诊断价值。结果：动脉瘤形态、结构均显示良好;对于瘤颈（内径、长度）及瘤体（内径、长度）作出较好评价;256排螺旋CTA可以很好的显示瘤颈及瘤体管壁钙化与血栓;256排螺旋CTA可以很好的显示髂动脉扭曲;术后支架腔显示良好,内漏静脉期与动脉期两者间差异没有统计学意义,平扫＋静脉期DLP〈平扫＋动脉期＋静脉期DLP。结论：动脉瘤术前检查,256排螺旋CT可以精确测量与评估动脉瘤的各项参数与指标,更好的指导临床;主动脉瘤腔及主动脉夹层内修复术后内漏患者CT复查,可直接行平扫及静脉期增强扫描,在保持与传统CTA检查相同诊断效能的同时,显著减低有效剂量。

The clinical application of 256-slice spiral CT in aortic aneurysm and aortic dissection

Objective：To evaluate the preoperative and postoperative assessment value of aortic aneurysm and aortic dissection with 256-slice spiral CT;and to explore to reduce the effective dose received by patients while maintaining the diagnostic performance of CTA to Endoleak for patients after repair operation for aortic aneurysms and aortic dissection cavity.Methods：Among 60 patients diagnosised and treated in our hospital,we analyzed their preoperative image of aortic aneurysm and aortic dissection with 256-slice spiral CT;and research status of aortic aneurysm after operation with 256-slice spiral CT.We compared Endoleak＇s image of arterial phase and venous phase,and analyzed their diagnostic value.Results：The shape and structure of aneurysm display clearly.Compared evaluating results and angiographic findings of aneurysmal neck diameter,length）and aneurismal body（diameter,length）,we found the differences between the two have no statistical significance.The intramural calcification and thrombus of aneurysmal neck and tumor can be shown clearly with 256-slice spiral CT angiography.Iliac artery distortion can be shown clearly with it.Cavity of intravascular stents displays clearly,and the differences of Endoleak between venous phase and arterial phase have no statistical significance;plain CT scan＋ venous phase DLP〈plain CT scan＋arterial phase＋venous phase DLP.Conclusion：For preoperative examination on aneurysm,parameter index can be precisely measured and evaluated with 256-slice spiral CT and give better guidance for clinic.Patients of Endoleak after repair operation for aortic aneurysms recheck use plain scan and enhance scanning.The effective dose received by patients can be reduced dramatically while maintaining the diagnostic performance of traditional CTA examination.