64排螺旋CTA在主动脉夹层中的诊断价值

目的探讨64排螺旋CT血管造影技术(CTangiography,CTA)及各种图像重建技术在主动脉夹层(AD)中的诊断价值。方法对41例AD患者行64排螺旋CTA扫描,将原始图像行多平面重建(MPR)、曲面和管腔拉直图(CPR和LS)、最大密度投影(MIP)、仿真内窥镜(VE)、容积再现(VR)重建。结果典型主动脉夹层(TAD)共35例,其中DeBakeyⅠ型、Ⅱ型、Ⅲa型、Ⅲb型各5、2、4、24例;不典型主动脉夹层(AAD)共6例。TAD患者中,35例均可显示真假腔、内膜片及分支血管受累情况,33例患者见初始破口,21例患者假腔内见血栓。轴位、MPR、CPR和LS是显示TAD的最好手段,MIP次之,VR可立体显示血管,VE可观察到破口的内部形态。结论 64排螺旋CTA及多种重建方法的应用能快速、无创、准确地诊断可无创性准确诊断各种主动脉夹层,为临床选择治疗方案提供更多的信息。

The diagnosing value of 64-detector spiral CT angiography on aortic dissection

Objective To explore the value of 64-detetor spiral CT angiography（CTA） and various types of imaging reconstruction techniques in diagnosing aortic dissection.Methods 41 cases with aortic dissection were scanned by 64-detetor spiral CTA,and original images reconstruction were performed including multiplanar reconstruction（MPR）,curved planar reconstruction（CPR）,lumen stripk（LS）,maximum intensity projection（MIP）,volume rendering（VR） and virtual endoscopy（VE）.Results 35 cases were typical aortic dissection（TAD）,among which 5 cases were DeBakey type Ⅰ,2 cases were type Ⅱ,4 cases were type Ⅲ a and 24 cases were type Ⅲ b.6 cases were atypical aortic dissection（AAD）.In TAD,the true and false lumens,the dissection membranes and the involvement of the branches were showed in all 35 cases.The primary crevasse were visible in 33 cases.21 cases of thrombus were seen in false lumens.The axial imaging,MPR,CPR and LS are the best way to display TAD,a little better than MIP.Blood vessels can be displayed by VR in the 3-dimension way and the interior forms of crevasse can be observed by VE.Conclusion The application of 64-detetor spiral CTA is a fast,noninvasive and accurate technique for diagnosis of various types of AD,which can provide more information for clinical treatment.