多层螺旋CT增强三期扫描肝内血管成像质量评价_临床医学论文.docVIP

多层螺旋CT增强三期扫描肝内血管成像质量评价_临床医学论文 多层螺旋CT增强三期扫描肝内血管成像质量评价_临床医学论文 【摘要】 目的 评价多层螺旋CT在肝内血管成像中的技术及应用 方法 回顾性分析57例肝脏检查，均应用16层螺旋CT行三期(动脉、门脉、静脉期)增强扫描;每期数据进行薄层小间隔重建后行容积再现技术(volume rendering technique，VRT)、最大密度投影(maximum intensity project，MIP)、多平面重建(multi planar reconstruction,MPR)等三维重建。由三位高年资医师对图像进行分析评价，取得一致后得出最终结论。 结果 肝脏动脉的一二级血管显示率可达到98%、75%。肝脏门脉的一二级血管显示率96%、73%。未显示部分主要因为肿瘤破坏、远端血管密度与肝脏密度无法清晰分辨等原因。肝静脉主干清晰显示达到75%。显示不清主要因为静脉密度与周围增强的肝脏组织相比不高，无法清晰分辨。重建图像可清晰显示占位病灶及其供血血管、肝内血管变异、门脉血栓、静脉曲张等疾病。 结论 多层螺旋CT肝脏三期扫描血管成像有重要临床价值。 【关键词】 多层螺旋CT; 肝脏血管;　血管成像 [Abstract] Objective To evaluate the clinical value and technique of multi-slice spiral CT in hepatic angiography. Methods We retrospectively analyzed 57 patients，all were performed with 16-slices spiral CT tri-phase scanning( arterial phase, venous phase, portal venous phase). The data were performed 3D reconstruction such as VRT, MIP, MPR etc .Three experienced doctors evaluated the images and came to conclusion after reach agreement. Results The displaying rates of the grade-1 and grade-2 of hepatic artery and portal were 98%,75%,97%,73% respectively. The others were mostly due to eroded by tumors or the density were unobvious between the live and the vein . 75% patients could display the veins clearly .The causation mainly were the density is no high to display the vein and the liver. The reconstruction images could obviously display the space occupying lesions and supplying vessels, abnormal hepatic artery, portal vein thrombosis、varicose veins etc. Conclusion Hepatic angiography with multi-slices spiral CT tri-phase contrast-enhanced scanning is very valuable. 　　[Key words] multi-slice spiral CT; hepatic vessels; angiography 　　多层螺旋CT应用逐步广泛，其优势与前景得到大家的认同。它扫描时间快、层厚薄，可进行多期扫描和各种三维重建。随着临床需求的发展，肝内血管成像也越来越重要。本文回顾分析以往检查病例，来评价多层螺旋CT在肝脏血管成像中的技术及应用的价值。 　　材料与方法 　　1.一般资料 临床申请肝脏CT平扫和增强的患者57例，男34例，女23例，年龄21～72岁，平均45岁，其中原发肝癌20例，肝转移癌5例，肝硬化8例，血管瘤6例，局灶性结节增生5例，肝动静脉漏3例，肝移植术后1例。 　　2.方法 2.1设备及参数:东芝16排螺旋CT Aquilion16，120KV，350MA，层厚1mm×16，螺距15-23，机架转速0.4s/rot，Medra