多层螺旋CT血管造影在主动脉瘤腔内带膜内支架置入术后并发症诊断中的应用

目的：探讨多层螺旋CT血管造影（CTA）在主动脉瘤腔内带膜内支架置入术后并发症诊断中的应用。方法：31例腹主动脉瘤和主动脉夹层腔内带膜内支架置入术后行多层螺旋CT血管造影，采用准直2.5mm，层厚3.0mm，螺矩6-8，重建方法为容积显示（VR）、表面遮盖显示（SSD）、最大密度投影法（MIP）及多层面重建法（MPR）。观察图像确定有无术后并发症，并比较4种重建方法对并发症的显示情况。结果：31例中有1例术后内支架出现局限性断裂，VR、MIP及MPR均清晰显示了内支架的变化，SSD未能显示。1例内支架展开不良，4种重建方法均明确显示；5例术后出现渗漏，VR及MPR清晰显示渗漏的部位、形态及内漏量，MIP、SSD仅显示其中的4例。在显示支架内血流情况及瘤周血栓方面，VR及MPR能明确支架内有无血栓形成及腔内带膜内支架置入术后的转归变化，VR及MPR显示1例术后支架内血栓形成，SSD及MIP未能显示。结论：多层螺旋CTA有利于主动脉瘤腔内带膜内支架置考试术后并发症的诊断；VR及MPR图像优于SSD及MIP，能为术后内支架情况作出更准确的判断 。

Multi-slice CT angiography in the diagnosis of complications of aortic aneurysms after endoluminal stentgrafting

Objective To evaluate the value of multi-slice CT angiography in the diagnosis of complications of abdominal aortic aneurysms or aortic dissection after endoluminal stentgrafting. Methods Multi-slice CT angiography was performed in 31 cases with abdominal aortic aneurysms and aortic dissection after endoluminal stentgrafting. 3D reconstruction techniques, including volume rendering (VR), surface shaded display (SSD), maximum intensity projection (MIP), and multi-plane reformation (MPR) were adopted. The images thus obtained were compared with each other. Results Of the 31 cases in this study, partial graft fracture occurred in one case and displayed on VR, MIP, and MPR images. Stent graft unexpandness occurred in one case and was displayed on all images. Peri-graft leakage occurred in 5 cases and all displayed on VR and MPR images, but only 4 cases were displayed on SSD or MIP images. Thrombosis within graft occurred in one case, and was demonstrated only on VR and MPR images. Conclusion Multi-slice CT angiography is favourable for demonstrating the complications of abdominal aortic aneurysms or aortic dissection after endoluminal stentgrafting. VR and MPR are superior to SSD or MIP in revealing the information of abdominal aortic aneurysms or aortic dissection after endoluminal stentgrafting.