主动脉病变螺旋CT三维成像的临床应用

目的　探讨螺旋CT在主动脉疾病诊断中的临床应用及其价值。　材料与方法　22例主动脉疾病（11例主动脉瘤、1例胸主动脉假性动脉瘤、7例主动脉夹层动脉瘤、1例大动脉炎、2例主动脉缩窄）者行螺旋CT增强检查，以表面覆盖显示(SSD)、多平面重建(MPR)、最大密度投影(MIP)、血管CT仿真内窥镜成像(CTVE)等多种方式重建。　结果　SSD均能很好显示病变的全貌，动脉瘤的大小、范围，夹层内膜片及与分支血管的关系等；MPR可较好显示附壁血栓，真假腔和内膜片；MIP可清楚显示管壁钙化和动脉瘤形态；CTVE可清晰显示内膜片、真假腔及血管的狭窄。　结论　诊断主动脉疾病综合应用螺旋CT的各种技术可基本取代X线血管造影，其为临床提供了一种可靠的诊断手段。

The clinical application of spiral CT in aortic diseases

Objective To study the clinical diagnostic value of spiral CT angiography in aortic di seases. Materials and Methods 22 patients with aortic diseases (11 aneurysm, 1 pseudoaneurysm, 7 dissection, 2 coarctation, 1 aorto-arteritis) were performed by spiral CT. SSD(Shaded surface display),MPR(Multiplanar reconstruction), MIP(Maximum intensity projection) and CTVE(CT virtual endoscopy) were used. Results SSD showed panorama of the lesion, the size and extent of aneurysm, intimal flap of dissection and the relation with arterial branches. MPR could display mural thrombus, flap, true and false lumen. MIP clearly showed the wall calcification and extent of aneurysm. CTVE could reveal the true and false lumen, flap and stenosis of arterial branches. Conclusions Application of combined techniques of spiral CT can basically replace X ray angiography in the diagnosis of aortic diseases. It provides another reliable modality for clinics.