螺旋CT血管造影及CT仿真内窥镜技术对主动脉夹层的诊断与评价

目的：探讨螺旋CT血管造影（SCTA）及CT仿真内镜（CTVE）技术对主动脉夹层诊断的临床应用价值。材料与方法；12例主动脉夹层行螺旋CT血管造影及二维和三维重建，二维重建包括多平面重建（MPR）及曲面重建（CRI）。三维重建包括表面遮盖成像（SSD）及最大密度投影（MIP），其中6例行主动脉CTVE成像。结果：SCTA横断面CT，MPR及CRI均显示12例主动脉夹层真腔与假腔，剥离内膜，瘤壁钙化及血栓，械断面CT显示4例内膜破裂口，MPR及CRI显示5例内膜破裂口，SSD及MIR显示12例真腔与假腔及剥离内膜，2例主动脉弓分支血管，SSD及MIP图像直观，立体感强，但均不能显示夹层动脉瘤内部结构情况及内膜破口，CTVE显示5例主动脉夹层真腔与假腔及其内壁，剥离内膜。结论：以主动脉SCTA的横断面CT图像为基础。结论其MPR，CRI，SSD，MIP及CTVE图像是诊断与评价主动脉夹层最有效无创伤性检查方法之一。

Application of SCTA and CTVE in diagnosing aortic dissection

Objective:To discuss the diagnostic value of SCTA and CTVE for aortic dissection.Material and Methods:Twelve cases of aortic dissection were examined by SCTA and MPR.CRI reconstructions were used as two-dimensional models.SSD and MIP reconstructions were used as three-dimensional models(3DCT).In six cases CT virtual endoscopy(CTVE)were performed.Results:Double lumen and intimal flap could be shown by transaxial CT,MPR and CRI in all of the12cases.Reentry of dissection could be demonstrated in4patients by transaxial CT and in5patients by MPR,CRI.Double lumen and intimal flap could be shown by SSD or MIP in12cases.Reentry and the intra-aneurysm al architecture of aortic dissection could not be shown by SSD and MIP.Double lumen,and intimal flap of aortic dissection were demonstrated by CTVE in5cases.Con clu sion:SCTA transaxial CT associated with MPR,CRI ,SSD,MIP and CTVE is an effective method in diagnosing and evaluating aortic dissection.