头颈部双能量减影CTA的临床应用.docVIP

头颈部双能量减影CTA的临床应用 　　摘要：目的 探?双能量减影CTA在头颈部血管性疾病中的临床应用价值。方法 收集2011年3月～2016年4月1200例临床怀疑颅颈部血管性疾病的患者行头颈部双能量减影CTA检查，通过双能软件内骨移除处理，对所有二维、三维图像行容积再现（VR）、最大密度投影（MIP）、多平面重组（MPR）及曲面重组（CPR）处理，并由2名有经验的放射科医师对其进行分析。另100例患者行常规减影CTA作对照组，比较双能量减影CTA和常规减影CTA的辐射剂量。结果 在1200例患者中，阳性532例，阴性668例，其中包括动脉瘤100例，动静脉畸形25例，颅颈部血管狭窄或闭塞292例，烟雾病5例，椎基底动脉延伸扩张症4例，脑膜瘤15例，海绵窦瘘1例，颈动脉体瘤6例，颈动脉及椎动脉起源异常58例。双能量减影CTA较常规减影CTA总辐射剂量降低了约64%。结论 头颈部双能量减影CTA具有无创、安全、简便快捷等优点，能清晰显示头颈部血管的情况，对头颈部血管性病变既有很高的诊断准确性，又能明显减少患者的辐射剂量，是一种很好的影像学检查手段。 　　关键词：双源CT；双能量减影CTA；头颈部血管性疾病 　　Clinical Application Value of Dual-Energy Subtract CTA of the Head and Neck 　　LI Zheng-hai 　　（Department of Radiology，Qujing First Peoples Hospital，Qujing 655000，Yunnan，China） 　　Abstract：Objective To explore clinical application value of dual-energy subtract CTA in diagnosis of cerebral and carotid vascular dieases. Methods Between Mar.2011 and Apr.2016，1200 patients with suspected of cerebral and carotid vascular dieases underwent dual-energy CT for the head and neck.All date was postprocessed using the software of dual-energy（head bone removal）.Two-dimensional and three-dimensional reformation were performed in all cases by means of curved vomule rendering（VR），maximum intensity projection（MIP），multi planar reconstruction（MPR） and curved planar reconstruction（CPR） respectively.All cases were analysed by two experienced radiologists. And 100 patients who underwent conventional subtraction CTA were selected as the control group， radiation dose between dual-energy CTA and conventional subtraction CTA were compared. Results 1200 patients，the were 532 normal patients and 668 abnormal patients. 100 patients were diagnosed as aneurysm（AM），25 patients as arteriovenous malformations（AVM）， 292 patients as cerebral and carotid artery stenosis or obliteration， 5 patients as moyamoya diease（MMD）， 4 patients as vertebrobsilar dolichoectasis（VBD）， 15 patients as meningioma， 1 patient as internal carotid-cavernous fistulae（ICCF）， 6 patients as cartid body tumor . The o