胰腺供血动脉的16层CT血管成像对比研究

目的 探讨16层CT血管成像3种重组技术：最大密度投影（MIP）、薄层最大密度投影（TSMIP）和容积重组（VR）对胰腺供血动脉的显示率，比较显示胰腺供血动脉的优势。方法 40例非胰腺病变的患者行腹部16层CT增强扫描和动脉期血管成像。统计TSMIP、MIP及VR对胰腺直接、间接供血动脉的显示率及显示状况。用配对X^2。检验观察显示率的差异；用配对秩和检验观察显示状况的差异。结果 （1）3种重组技术对胰腺间接供血动脉的显示率均为100％（40／40）。TSMIP、MIP、VR对胰十二指肠上后动脉（PSPDA）的显示率分别为92．5％（37／40）、77．5％（31／40）、67．5％（27／40）；对胰十二指肠上前动脉（ASPDA）的显示率分别为95．0％（38／40）、82．5％（33／40）、75．0％（30／40）；对胰十二指肠下动脉（IPDA）的显示率分别为92．5％（37／40）、75．0％（30／40）、57．5％（23／40）。（2）TSMIP与VR对ASPDA、PSPDA、IPDA的显示率的差异有统计学意义（X^2值分别为6．27、7．81、13．07、P值均〈0．01）；TSMIP与MIP对IPDA的显示率差异有统计学意义（X^2值为4．50，P〈0．05）。（3）TSMIP与MIP对胃十二指肠动脉（Z=-3．317，P=0．001）、胃左动脉（Z=-3．557，P=0．000）、肝固有动脉（Z=-2．810，P：0．005）、ASPDA（Z=-4．796，P=0．000）、PSPDA（Z=-4．400，P=0．000）和IPDA（z=-4．811，P=0．000）的显示状况的差异有统计学意义：TSMIP与VR对胃十二指肠动脉（Z=-3．162，P=0．003）、胃左动脉（Z=-3．051，P=0．002）、肝固有动脉（Z=-2．460，P=0．014）、ASPDA（Z=-5．166，P=0．000）、PSPDA（Z=-5．056．P=0．000）和IPDA（Z=-5．564，P=0．000）的显示状况的差异有统计学意义；MIP与VR对ASPDA（Z=-3．000，P=0．002）、PSPDA（Z=-2．352，P=0．019）和IPDA（Z=-3．500，P=0．000）显示状况的差异有统计学意义。结论 TSMIP显示胃左动脉、肝固有动脉、胃十二指肠动脉和胰腺直接供血动脉优于MIP及VR。MIP显示胰腺直接供血动脉优于VR。

Angiography of the feeding arteries of pancreas with multidetector-row CT: comparison of maximum intensity projection, thin-slice maximum intensity projection and volume rendering

Objective To measure the frequency of visualization of pancreatic feeding arteries with thin-slice maximum intensity projection(TSMIP),maximum intensity projection(MIP) and volume rendering(VR) of computed tomography angiography(CTA) techniques using multidetector-row CT(MDCT).To compare the advantages of different techniques.Methods Dual-phase CTA using a Siemens Sensation 16 scanner was performed in 40 cases meeting the including and excluding criteria.CTA of pancreatic artery were made using the TSMIP,MIP and VR techniques.Two radiologists evaluated together and recorded the frequency and degree of visualization of the direct and indirect feeding arteries of pancreas.Results The indirect pancreatic feeding arteries were all seen in each technique.In TSMIP,MIP,VR,visualization rates of PSPDA were 92.5%,77.5%,and 67.5%,respectively;ASPDA,95.0%,82.5%,75.0%;IPDA,92.5%,75.0%,57.5%.There was significant difference in visualization rates of PSPDA,ASPDA,IPDA between TSMIP and VR.So did IPDA between TSMIP and MIP.There was significant difference in the degree of visualization of LGA,PHA,GDA and the direct feeding arteries among TSMIP,MIP or VR.So did the direct feeding arteries between MIP and VR.Conclusion TSMIP is superior to MIP and VR in the visualization of LGA,PHA,GDA and direct feeding arteries of pancreas.MIP is superior to VR in the visualization of direct feeding arteries of pancreas.