阴部内动脉的多层螺旋CT血管造影成像及价值

目的:探讨64层螺旋CT血管造影(CTA)对阴部内动脉及其分支三维成像的可行性及价值。方法:非血管病变的男性156例,年龄20～70岁,其中20～55岁(A组)83例,56～70岁(B组)73例;另有动脉性勃起功能障碍(ED)患者7例,年龄43～70岁(C组),采用64层CT行下腹部CTA检查。扫描图像传至ADW4.3工作站作阴部内动脉及其分支的最大密度投影(MIP)、容积重建(VR)重建及血管分析,由3名主管技师根据阴部内动脉及其分支的清晰度及连续性对MIP、VR图像分3级盲评,并在血管探针图像上测量阴部内动脉及其分支多个位置管径的大小。结果:MIP图像对A、B组间阴部内动脉及其分支的显示没有显著差异(P>0.05),而VR图像有显著差异(P<0.05),但两种重建方式对阴部内动脉及其分支的显示没有显著差异(P>0.05)。两侧、同侧阴部内动脉及分支A、B组各平面管径没有显著差异(P﹥0.05)。7例ED患者其VR、MIP显示为Ⅲ级,并清楚显示阴部内动脉及其分支狭窄、闭塞的程度和位置。结论:CTA能清晰显示阴部内动脉及其分支的三维成像,对阴部内动脉病变引起的ED的诊断和治疗具有重要的价值。

Multi-slice spiral computed tomography angiography of internal pudendal arteries: imaging and value

Objective: To investigate the feasibility and value of multi-slice spiral computed tomography angiography(CTA) in 3D imaging of internal pudendal arteries and their branches.Methods: Using 64-slice spiral computed tomography,we performed hypogastric CTA for 156 twenty to seventy years old males without vascular diseases.We assigned them to groups A(n = 83,20 to 55 yr old) and B(n = 73,56 to 70 yr old),and included 7 male patients with arterial erectile dysfunction(AED) aged 43 to 70 years in group C.We conducted maximum intensity projection(MIP),volume rendering(VR) and vascular analysis on the internal pudendal arteries and their branches,divided the MIP and VR images into 3 levels according to the resolution and continuity of the internal pudendal arteries and their branches for blind evaluation,and measured their diameters at various positions.Results: VR images of the internal pudendal arteries and their branches revealed significant differences between groups A and B(P<0.05),but not MIP images(P>0.05).There were no dramatic differences between MIP and VR in displaying internal pudendal arteries and their branches(P>0.05),nor any remarkable differences in the diameters of bilateral internal pudendal arteries and their branches at different levels in groups A and B(P>0.05).VR and MIP showed the 7 AED cases at grade Ⅲ,and clearly revealed the degree and position of stenosis and occlusion in the internal pudendal arteries and their branches.Conclusion: CTA can display clear 3D images of internal pudendal arteries and their branches,and has a valuable role in the diagnosis and treatment of ED induced by internal pudendal artery diseases.