电子束CT在主动脉瘤诊断中的临床应用

目的　评价电子束CT(electronbeamcomputedtomography ,EBCT)血管造影及三维重建在主动脉瘤诊断中的临床应用价值。方法　收集经EBCT诊断的主动脉瘤 3 2例 ,男 2 4例 ,女 8例 ,其中 9例与手术结果作了对照。胸主动脉扫描采用单层步进容积增强扫描序列 (SVS ) ,心电门控采像 ;腹主动脉扫描采用单层连续容积增强扫描序列 (CVS ) ,无心电门控。所得图像进行后处理三维重建 ,主要采用多层面重组法 (MPR )、最大密度投影法 (MIP )、表面阴影显示法 (SSD )、容积再现法 (VR )进行处理。结果　 3 2例主动脉瘤中 ,真性主动脉瘤 8例 ,假性动脉瘤 5例 ,夹层动脉瘤 19例。其中 9例动脉瘤接受手术治疗 ,手术证实EBCT诊断符合率为 10 0 %。结论　EBCT血管造影可获得高分辨率的大血管解剖影像 ,三维重建图像能直观地显示主动脉瘤病变的范围、大小形态及夹层动脉瘤内膜撕裂口 ,对诊断具有优良价值 ,并能指导手术。在主动脉瘤的诊断上 ,可取代常规血管造影。

Clinical Application of Electron Beam Computed Tomography in the Diagnosis of Aortic Disease

Objective To evaluate the value of electron beam computed tomography (EBCT) angiography and three-dimensional reconstruction in the diagnosis of aortic aneurysm.Methods 31 patients(24 male,7 female) with aortic aneurysm were performed scanning by EBCT . The scanning methods were contrast enhanced single slice volume scanning(SVS) and continuous volume scan(CVS); the 3D reconstruction methods were multiple planar reconstruction (MPR), maximum intensity projection(MIP), shaded surface display(SSD) and volume rendering(VR).Results Of 31 aortic disease, 7 cases were aortic aneurysm, 19 cases were aortic dissection and 5 cases pseudoaneurysm. 9 patients were performed operation and the diagnosis of EBCT coincided well with the operative findings in all cases. Conclusion EBCT angiography can obtain high quality images. EBCT angiographic findings and 3D imagings are in helpful accurate diagnosis and direct surgical operation. The 3D images can directly show the shape and range of aortic aneurysm and the tears of the dissection of pseudoaneurysm. It may substitute conventional aortic angiography in the diagnosis of aortic disease.