多排螺旋CT血管成像技术(MDCTA）诊断内脏动脉瘤的临床价值_临床医学论文.docVIP

多排螺旋CT血管成像技术(MDCTA）诊断内脏动脉瘤的临床价值_临床医学论文 多排螺旋CT血管成像技术(MDCTA）诊断内脏动脉瘤的临床价值_临床医学论文 作者：胡海菁 徐新超 罗志坤 林小慧 杜丽云 【摘要】 目的 探讨多排螺旋CT血管成像技术（MDCTA）在腹腔内脏动脉瘤诊断和治疗中的价值。 方法 回顾分析经MDCTA诊断的腹腔内脏动脉瘤28例（其中包括10例经内脏动脉造影（DSA）确诊 ） 结果 28例患者中发现动脉瘤31枚，其中脾动脉瘤9枚，肝动脉瘤6枚，腹腔干动脉瘤5枚，肠系膜上、下动脉瘤分别为5枚和1枚，肾动脉5枚。VR、MIP、MPR可准确、清晰地显示瘤体位置、形态、范围、瘤壁、载瘤动脉和与周围血管的关系，VE可清晰显示腔内血栓和钙化。结论 临床诊断内脏动脉瘤极为困难，MDCTA是简单、快速、无创、安全、可靠的血管成像技术，在诊断内脏动脉瘤方面，具有分辨率高，快速，准确，经济等优点，对腹腔内脏动脉瘤的检出具有较高的敏感性和特异性，在一定程度上完全可替代DSA检查，它提供的详尽信息为尽快确定治疗方案提供依据。 【关键词】 体层摄影术 X线计算机 血管造影术 内脏动脉瘤 Abstract Objective To investigate the value of multi-slice spiral CT angiography (MDCTA) in the diagnosis and treatment of abdominal visceral artery aneurysms. Methods 28 patients with abdominal visceral artery aneurysms, diagnosed by MDCTA, were analyzed retrospectively, of which 10 cases were finallly diagnosed by DSA.. Results Found in the 28 patients were 31 artery aneurysms, including 9 splenic artery aneurysms, 6 hepatic artery aneurysms, 5 celiac artery aneurysms, 5 superior mesenteric artery aneurysms, 1 inferior mesenteric artery aneurysm and 5 renal artery aneurysms. The location, shape, ambit, aneurismal wall, parent artery and the relationship with the adjacent vessels were showed clearly and accurately with volume rendering (VR), maximum intensity projection (MIP) and multiple planar reconstruction (MPR). Intraluminal thrombus and calcification could also be displayed clearly with VE. Conclusion A simple, high-speed, non-invasive, safe and reliable angiographic technique，MDCTA is a feasible method with highly qualified images, high-speed，exact and economic in the diagnosis of visceral artery aneurysms.It has higher sensitivity and specificity in the diagnosis of abdominal visceral artery aneurysms. To some extent, MDCTA can take the place of DSA and provide exhaustive information for treatment. Key words: tomography; X-ray computed; angiography;visceral artery aneurysms 内脏动脉瘤即腹主动脉所属各内脏动脉及其分支所产生的动脉瘤，随着我国高血压及动脉硬化患者的增多及检查技术的进步，其发病率在逐年上升，目前世界文献报道已愈3000例，国内报道尚不多[1,