螺旋CT血管造影在颅底肿瘤中的应用价值

目的：探讨颅底肿瘤螺旋CT血管造影（SCTA）的成像技术及其应用价值。方法：16例颅底肿瘤,MRI明确诊断后行SCTA。SCTA与MRI、手术对照。螺旋扫描层厚2．0mm,间距1．0mm,螺距1．0－1．25,均以3．0ml/s速度注射对比剂120ml;用表面遮盖法（SSD）重建三维图像,5例行伪彩SSD重建及模拟手术入路。结果：SCTA清楚显示了14例颅底肿瘤的形态及其与大血管、颅骨的三维关系,而1例颅咽管瘤、1例胶质瘤瘤体未显示,仅显示了受压移位的邻近血管及其与颅骨的关系。SCTA的三维图像及模拟手术入路为治疗方案的制定提供了重要信息。结论：SCTA提供的颅底肿瘤与邻近血管及颅骨关系的三维图像,是对常规二维图像的重要补充,对临床治疗有重要指导价值。

Clinical application of spiral CT angiography in the skull base neoplasms

Objective: To research on the clinical value and techniques of spiral CT angiography (SCTA) in the examination of skull base neoplasms. Methods: Sixteen patients who had neoplasms near the skull base were examined with SCTA and MRI, and the findings of SCTA were compared with MRI and surgery.The thickness of spiral scanning was 2.0 mm, index 1.0 mm,pitch 1.0 1.25. We injected 120 ml contrast medium intravenously at a rate of 3.0 ml/s.The surface shaded display(SSD) technique was used to reconstruct the 3D images in every case and the color SSD images were used to imitate the neurosurgical approach in 5 patients. Results: SCTA clearly demonstrated the 3D shapes of the neoplasms and their relationship with adjacent vessels and the skull base.The bodies of a craniopharyngioma and a glioma were not shown in the SCTA images but the adjacent vessels pressed and the skull base were shown clearly. The 3D images of SCTA and simulated neurosurgical approach supplied important information to the therapy planning. Conclusion: SCTA can provide 3D images of the skull base neoplasms and clearly show their relationship with adjacent vessels and bones.They are important supplementary to conventional 2D images and have high directive value to therapy.