16层螺旋CT颈部血管成像的初步临床应用

目的:探讨颈部血管(颈动脉、椎动脉)16层螺旋CT血管造影成像技术及其临床应用价值。材料和方法:38例临床怀疑颈动脉及椎动脉狭窄者,经16层螺旋CT扫描后,用薄层横断面放大图像(MTI)及最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)等后处理方法,进行管腔及管壁斑块的形态学显示,并用高级血管分析软件测量狭窄段径线、狭窄段长度等作定量分析。结果:38例共计76支颈动脉、76支椎动脉CTA图像中,正常颈动脉血管40支,狭窄血管36支,其中1支颈总动脉中度狭窄者合并有动脉瘤;76支椎动脉中,6支椎动脉狭窄,受压于邻近椎体骨质;38例中有9例行颈动脉DSA检查,18例做了颈动脉多普勒超声(TCD),7例DSA和16例TCD对照结果一致,2例CTA轻度狭窄者TCD显示正常,11例颈动脉斑块均为混合密度斑块。结论:16层螺旋CT颈部血管成像图像质量满意,重建图像质量高,能较准确显示管腔狭窄及管壁斑块形态学改变,满足临床诊断需要,具有很好的临床筛查及实用价值。

Elementary Application of 16-slice Spiral CT Angiography in Extracranial Carotid and Vertebral Artery

Purpose:To discuss the technique and clinical application of 16-slice spiral CT angiography in extracranial carotid artery and vertebral artery.Materials and Methods:38 cases with suspicious carotid artery stenosis were scanned with 16 slice spiral CT in carotid and vertebral artery using different reconstruction including magnified transverse images(MTI),maximum intensity projection(MIP),multi-planar reconstruction(MPR),curved planar reconstruction(CPR)to display anatomic artery stenosis,the degree and length of artery stenosis were recorded by advanced angiography analysis.Results:Of all 76 carotid arteries,forty carotid arteries are normal;thirty six carotid arteries are various degree of stenosis,including one moderate common carotid artery stenosis with aneurysm.There are six stenotic sites in all vertebral arteries owing to osteosclerosis of vertebrate.Among them,the carotid artery stenosis degree of three cases is agreement between MSCTA and DSA,the results of twenty four cases is in agreement between MSCTA and TCD respectively.Conclusion:16-slice spiral CTA was proved to have good sources and reconstructive image quality,it is satisfied the need of clinical diagnosis and appears to be an excellent screening examination in clinics.