螺旋CT血管成像对腹主动脉瘤的诊断与测量

目的探讨螺旋CT血管成像(SCTA)及三维重建对腹主动脉瘤(AAA)的诊断价值和SCTA测量对血管内支架植入术术前支架选择的临床应用。方法对35例腹主动脉瘤患者行SCTA成像,于二维原始横断面、最大密度投影(MIP)图像上测量瘤颈长度、直径,瘤体大小,双髂动脉的直径及长度。为选择术式和支架提供准确依据。结果SCTA及三维重建可以显示腹主动脉瘤管径的扩张程度、管壁的钙化和腔内血栓,腹腔干、肠系膜上动脉、双肾动脉、肠系膜下动脉等血管分支及双髂动脉受累情况和瘤周情况。于二维原始横断面及MIP图像上测量数据与手术结果基本相符,3例依据我们测量的结果定制的支架经手术证实与需求相符。结论SCTA对腹主动脉瘤的诊断、评价各分支血管受累情况、术式的选择及内膜支架的定制具有重要的临床应用价值。

Spiral CT angiography in diagnosis and measurementof abdominal aortic aneurysm

Objective To assess the diagnostic value and measurement of spiral CT angiography (SCTA) and three-dimensional reconstruction in abdominal aortic aneurysm (AAA), and to evaluate the clinical application of SCTA measurement in the preoperative choice of stent. Methods Thirty-five patients with AAA received SCTA scanning. The information was obtained regarding the size and feature of AAA, length and diameter of aneurysms neck, as well as bilateral iliac arteries in both MIP and two-dimensional reconstruction images, which offered an accurate proof for the choice of operation style and the size of stent. Results SCTA images could clearly show the dilation extent of lumen, the calcification of arterial wall, intravascular thrombosis, and the injured situation of coeliac trunk. Superior and inferior mesenteric artery, both renal arteries as well as peri-aneurysm could be revealed. Data obtained from two-dimensional and MIP images accorded with the operation. Three cases of stent selected by this method matched well to the need of operation. Conclusion SCTA has important applied value in diagnosing AAA, evaluating the branches involved, and choicing the operation style and stent.