螺旋CT肺动脉血管成像的技术及临床应用

螺旋CT血管成像 (helicalcomputedtomographyangiography ,CTA)自应用于临床以来 ,因检查时间短、创伤性小、图像后处理技术多样 ,已在全身各个部位大、中血管中得到普遍应用[1 3 ] 。多层螺旋CT(multi slicespiralCT ,MSCT)的问世 ,不仅使螺旋CT的时间分辨率得以提高 ,其空间分辨率及图像后处理技术也得到很大改进 ,从而使CTA的图像质量和评价的准确度得到很大的改善和提高[4,5] 。肺血管疾病 ,尤其是肺栓塞及中央型肺癌严重影响着患者的处理与预后。本文从CTA的技术入手 ,探讨CTA在肺动脉疾病中的临床应用价值。技术方面1.扫描…     

多层螺旋CT血管成像技术临床应用进展

随着多层螺旋CT扫描及重组技术的进展，CT血管成像的应用范围也越来越广。对多层螺旋CT血管成像的技术优势、技术特点以及临床研究热点做一综述。     

多层螺旋CT血管成像技术临床应用进展

随着多层螺旋CT扫描及重组技术的进展,CT血管成像的应用范围也越来越广.对多层螺旋CT血管成像的技术优势、技术特点以及临床研究热点做一综述.     

16层螺旋CT冠状动脉血管成像技术临床应用

目的:探讨16层螺旋CT冠状动脉成像技术临床应用价值。方法:对45例临床诊断或可疑冠心病的住院患者行16层螺旋CT冠状动脉回顾性心电门控平扫及增强扫描。将增强扫描图像传送到Wizard图像工作站进行最大密度投影(MIP)、多平面重组(MPR)、曲面重组(CPR)、容积再现技术(VRT)及平带多平面重组(RMPR)。并将VRT及MIP重组像为参照,用平扫图像对冠状动脉各支段进行钙化积分。结果:左冠状动脉主干(LM)、左前降支近中段(LAD1、LAD2)、第一对角支(D1)、左回旋支(LCX)及右冠状动脉近段(RCA1)显示均45例(100%),左前降支远段(LAD3)23例(51%),第二对角支(D2)30例(67%),第三对角支(D3)24例(53%),第一左缘支(M1)36例(80%),第二缘支(M2)28例(62%),右冠状动脉中段(RCA2)41例(91%),右冠状动脉远段(RCA3)43例(96%)及后降支(PDA)34例(76%)。左冠状动脉主干钙化12例(27%),左前降支近中段钙化有29例(64%),左回旋支钙化例数22例(49%),右冠状动脉近中段钙化有24例(53%)。结论:16层螺旋CT可对冠状动脉进行钙化积分并准确显影,是冠状动脉粥样硬化疾病筛选和诊断的首选方法。     

CT血管成像的基本原理及临床应用

本阐述了ＣＴ血管成像的基本原理、临床应用价值及其局限性与发展前景。并与传统血管造影、ＤＳＡ、Ｄｏｐｐｌｅｒ超声和ＭＲＡ进行比较。     

CT血管成像技术在肾动脉的应用

多层螺旋（MS）CT血管成像（multislice spiral CT angiography,MSCAT）即CT扫描和三维（3D）重建技术的综合利用。是目前MSCT成像的一项新技术。我院自2001年开始使用多MSCT机,颇有收益。本文旨在探讨MSCTA技术在肾动脉疾病中的应用价值和方法。     

三维螺旋CT血管成像及其临床应用

螺旋ＣＴ血管成像（ＣＴＡ）是评价多种血管病变有希望的检查技术，这些信息以往只有常规血管造影（ＣＡ）才能获得。一次ＣＴＡ３Ｄ数据采集使之可在无数视角观察病变。金属假体对螺旋ＣＴＡ成像影响不大。与ＣＡ相比，螺旋ＣＴＡ ３Ｄ成像的创伤性、费用及时间均减少。本阐述了螺旋ＣＴＡ成像技术及临床应用。     

主动脉夹层螺旋CT血管造影成像技术及临床应用

主动脉夹层是主动脉最常见的急诊性疾病[1] ,ＳＣＴＡ自1992年应用于临床至今[2 ] ,伴随着其影像后处理技术的渐趋成熟 ,它在对本病的早期诊断、精确显示解剖细节、术前模拟的评估和术后随访等方面显示了无比的优越性 ,被认为是诊断主动脉夹层的首选方法[2～ 11] ,甚至可替代ＤＳＡ ,本文拟对此专题作一综述。1　成像技术1.1　原理　ＳＣＴＡ是根据血液循环时间在靶血管内造影剂高峰期内一次屏气完成一个较大部位的容积数据采集 ,然后进行影像后处理获得血管影像的方法[12 ,13] 。1.2　方法1.2 .1　确定成像范围　ＳＣＴＡ成像前应合理确定…     

主动脉夹层螺旋CT血管成像的临床应用

主动脉夹层动脉瘤是一种严重危害人类健康的主动脉疾病。近几年来，由于我国饮食结构的改变及检查技术的提高，其发病率逐年上升的趋势早期死亡率高达1-2％。我院自引进16层螺旋CT及0．5T超导MRI以来，对临床疑似主动脉夹层动脉瘤18例分别进行检查。旨在讨论MSCT的临床应用价值。     

多层螺旋CT冠状动脉造影的扫描技术及临床应用

目的：探讨多层螺旋CT冠状动脉造影的成像技术及临床应用价值。方法：对68例[包括40例无明显心脏疾患的志愿者，25例冠心病患者，2例经皮冠冠状动脉成形术（PTCA）术后5个月和1例主动脉瓣膜置换术后的患者]进行了多层螺旋CT冠状动脉造影（multi-slice spiral CT coronary angiography,MSSCTCA)并行冠状动脉三维重建，其中25例冠心病患者并进行了选择性冠状动脉造影检查，以此为金标准，比较MSSCTCA对冠状动脉病变的检出率（未作冠状动脉造影的，只是用于评价多层螺旋CT对冠脉各支的显示能力，如显示哪几支、显示长度，示涉及有否冠状动脉疾患的显示）。结果：MSSCTCA对冠状动脉近中段显示清晰，显示率可达90％以上；对冠状动脉狭窄检出率为87．5％。结论：MSSCTCA可作为冠状动脉粥样硬化疾患的筛选手段及冠状动脉术后复查的首选方法。     

Current status of coronary multislice CT angiography

Multislice computed tomography (MSCT) is an emerging technique which has an enormous potential to improve the current practice of coronary artery imaging. This article reviews the current status of coronary MSCT angiography (MSCTA) with emphasis on the imaging techniques and clinical utilities of 16-slice CTA. Results and experiences gained from coronary MSCTA in the past few years have taught us that accurate diagnosis of coronary artery disease relies on good technical studies and can be achieved by optimizing image parameters including image timing and image reconstruction ECG-trigger delay. Current clinical applications of coronary MSCTA include: quantitative assessment of coronary artery stenosis, characterization of coronary atherosclerotic plaques, and follow-up of coronary artery stent and bypass graft. Furthermore, MSCT has brought an increasing awareness to the amount of radiation used in CT. This has prompted CT researchers and manufacturers to improve various techniques and develop new strategies to reduce radiation dose. It is anticipated that MSCT will become a sensitive and accurate tool for detecting coronary artery disease and monitoring outcomes after treatment for coronary artery disease.     

16层CT血管造影在肺动脉栓塞诊断中的应用价值

目的 探讨16层CT肺动脉造影对肺动脉栓塞(PE)的诊断价值.方法 对24例PE患者行16层CT血管造影检查,采用多平面重建(MPR)、最大密度投影(MIP)、容积再现(VR)多种图像后处理技术,并结合轴位图像进行综合分析.结果 24例均能显示肺动脉栓塞的部位、范围、局部管腔狭窄程度,19例急性肺动脉栓塞的直接征象为“截断征”、“双轨征”;5例慢性肺动脉栓塞主要表现为肺动脉管腔内偏心性、附壁性的充盈缺损.结论 16层CT血管造影是诊断肺动脉栓塞及其溶栓疗效评价和随访最有效的无创性检查方法之一.     

Current technology and clinical applications of three-dimensional angiography

Three-dimensional (3D) angiography was first proposed by Cornelius and advanced into clinical practice by Voigt in 1975. Since then, a variety of improvements have been developed as a result of the increased speed and data transfer afforded by modern computers. Recent publications by Fahrig and others have brought 3D angiographic imaging to the forefront. The 3D evaluation of cerebral aneurysms and arteriovenous malformations no longer is a clinical curiosity, but an absolute necessity.     

Coronary CT angiography: current status and continuing challenges

Coronary CT angiography has been increasingly used in the diagnosis of coronary artery disease owing to rapid technological developments, which are reflected in the improved spatial and temporal resolution of the images. High diagnostic accuracy has been achieved with multislice CT scanners (64 slice and higher), and in selected patients coronary CT angiography is regarded as a reliable alternative to invasive coronary angiography. With high-quality coronary CT imaging increasingly being performed, patients can benefit from an imaging modality that provides a rapid and accurate diagnosis while avoiding an invasive procedure. Despite the tremendous contributions of coronary CT angiography to cardiac imaging, study results reported in the literature should be interpreted with caution as there are some limitations existing within the study design or related to patient risk factors. In addition, some attention must be given to the potential health risks associated with the ionising radiation received during cardiac CT examinations. Radiation dose associated with coronary CT angiography has raised serious concerns in the literature, as the risk of developing malignancy is not negligible. Various dose-saving strategies have been implemented, with some of the strategies resulting in significant dose reduction. The aim of this review is to present an overview of the role of coronary CT angiography on cardiac imaging, with focus on coronary artery disease in terms of the diagnostic and prognostic value of coronary CT angiography. Various approaches for dose reduction commonly recommended in the literature are discussed. Limitations of coronary CT angiography are identified. Finally, future directions and challenges with the use of coronary CT angiography are highlighted.     

双源CT及其临床应用

近年来多层螺旋CT技术的持续进步不仅使冠状动脉的CT成像进入了临床实用阶段,而且在有选择性的患者中有望代替有创性的冠状动脉造影检查.从4层CT到64层CT时间分辨率不断提高的同时,也提高了冠状动脉CT的诊断能力.     

Computed tomography angiography: principles and clinical applications

Clinical applications of computed tomography (CT) angiography have increased with the improved technology of multidetector CT systems. Adequate contrast enhancement and the timing of image acquisition are key elements in producing technically adequate CT angiograms. This review article provides guidelines and protocols for four-, eight- and 16-channel multidetector systems in studies of the thoracoabdominal aorta, aortoiliac, and abdominal visceral vasculature, abdominal and extremity run-off studies, and carotid/cerebral CT angiography.     

Mesenteric CT angiography: a discussion of techniques and selected applications

Sixty-four slice MDCT with advanced three-dimensional (3D) visualization software provides a unique opportunity for noninvasive evaluation of the mesenteric vasculature. Although standard axial computed tomography (CT) scanning has always allowed identification of the mesenteric arteries and veins, it is limited in its ability to adequately image small branches and complex anatomy. However, the submillimeter collimation possible with 64-slice CT scanners now allows the acquisition of true isotropic data and therefore high spatial resolution is now maintained in any imaging plane. This ability to visualize the mesenteric vasculature in real-time using 3D rendering and multiplanar reconstruction is crucial for comprehensive review of the complex mesenteric vessels. In this article, we discuss CT scanning protocols and 3D imaging techniques that can be utilized for CT angiography of the mesenteric vessels. Additionally, we will discuss several key conditions that illustrate the value of 3D imaging over standard axial images in mesenteric CT angiography.     

CT enteroclysis: technique and clinical applications

CT enteroclysis (CTE) has been gradually evolving with technical developments of spiral and multidetector row CT technology. It has nowadays become a well-defined imaging modality for the evaluation of various small bowel disorders. Volume challenge of 2L of enteral contrast agent administrated to the small bowel via a nasojejunal catheter ensures luminal distension, the prerequisite for the detection of mural abnormalities, also facilitating the accurate visualization of intraluminal lesions. CT acquisition is centered on small bowel loops, reconstructed in thin axial slices and completed by multiplanar views. Image analysis is essentially done in cine-mode on work-stations. CTE is of particular diagnostic value in intermediate or advanced stages of Cohn's disease, including the depiction of extraintestinal complications. It has become the imaging modality of choice for the localization and characterization of small bowel tumors. The cause and degree of low-grade small bowel obstruction is more readily analyzed with the technique of CTE than conventional CT. Limitations of CTE concern the assessment of pure intestinal motility disorders, superficial mucosal lesions and arteriovenous malformations of the small bowel, which are not consistently visualized. CTE should be selectively used to answer specific questions of the small bowel. It essentially contributes to the diagnostic quality of modern small bowel imaging, and therefore deserves an established, well-defined place among the other available techniques.