多层螺旋CT胸部薄层平扫肺血管三维重组诊断肺动静脉瘘的价值

目的评价利用多层螺旋CT胸部薄层平扫图像进行肺血管三维重组诊断肺动静脉瘘的价值。方法回顾性分析13例经CT增强肺血管三维成像证实的肺动静脉瘘患者共17个肺动静脉瘘病灶的CT胸部薄层平扫图像并进行肺血管三维重组，联合多平面重组（MPR）、曲面重组（CPR）、容积再现（VR）、最大密度投影（MIP）、薄层多向倾斜VR和MIP等重组技术，比较与CT增强诊断肺动静脉瘘的一致性、辐射剂量和碘对比剂用量。结果CT胸部薄层平扫图像联合应用多种三维重组技术清楚显示了全部17个肺动静脉瘘囊瘤的大小、形态，供血动脉和引流静脉，对全部病例均做出了明确诊断，辐射剂量是CT增强的33％～50％，不使用对比剂而CT增强需要使用45～85ml碘对比剂。结论利用多层螺旋CT胸部薄层平扫图像进行肺血管三维重组能对肺动静脉瘘做出准确诊断并明显降低患者的辐射剂量和避免碘对比剂的使用，大大增加了检查的安全性，在临床上有较大价值。

The Diagnostic Value of MSCT Pulmonary Vessels Three-dimensional Reformation Based on None-enhanced thin-slice Chest Images in Pulmonary Arteriovenous Fistula

Objective To evaluate the diagnostic value of MSCT pulmonary vessels three- dimensional reformation based on none-enhanced thin-slice chest images in pulmonary arteriovenous fistula（PAVF）. Methods Retrospectively analyzed none-enhanced thin-slice chest images of 17 PAVFs of 13 patients confirmed by enhanced CT and performed pulmo- nary vessels three-dimensional reformation combined applications of Multi-Planar Reformation（MPR）, Curved-Planar Reformation（CPR）, Volume Rendering（VR）, Maximum Intensity Projection（MIP）, thin-slab VR and MIP of multi-direction tilt, compared diag- nostic coherence, radiation dose and volume of iodine contrast medium to enhanced CT. Results None-enhanced thin-slice chest images combined different three-dimensional refor- mations clearly displayed the size, shape of cystic aneurysm, supplying artery and drain- ing vein and diagnosed all 17 PAVFs correctly, the radiation dose was about 33%-50% of enhanced CT＇s, it didn＇t use but enhanced CT used 45-85ml iodine contrast medium. Conclusion MSCT pulmonary vessels three-dimensional reformation based on none-en- hanced thin-slice chest images not only diagnoses PAVF correctly, but also reduce radiation dose and don Zt use iodine contrast medium, it is sale and valuable in clinical practice.