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目的分析多层螺旋CT血管成像(CT angiography,CTA)对主动脉弓凸侧分支血管的显示,观察主动脉弓分支的相关变异。方法搜集颈胸结合部CTA患者237例,采用容积再现(VR)和多平面重组(MPR)等多种图像后处理技术,获得主动脉弓部重组图像。多角度、多平面、多方位立体观察主动脉弓及其主要分支的解剖结构,分析主动脉弓分支的相关变异情况。结果主动脉弓分为两种类型,即:标准型和变异型,以标准型最常见,占总病例数的89.03%;变异型占总病例数的10.97%,其中可见4种不同类型的变异。左侧椎动脉自主动脉弓发出并位于左颈总动脉(left common carotid artery,LCCA)和左锁骨下动脉(left subclavian artery,LSA)之间者占变异型患者的50%,为总病例数的5.49%;LCCA自头臂干(brachiocephalic trunk,BT)发出者占变异型的38.46%,为总病例数的4.22%;LCCA发自于BT并存左椎动脉发自主动脉弓并位于LCCA和LSA之间者占变异型的7.69%,为总病例数的0.84%;右位主动脉弓伴迷走左锁骨下者占变异型的3.85%,为总病例数的0.42%。结论多层螺旋CTA能为临床提供主动脉弓变异的解剖信息。
Objective To analyze the manifestation of the branch of the convex side of the aortic arch by multi-slice CT angiography (CTA) and observe the related variation of aortic arch. Methods Totally 237 CTA patients with cervical-thoracic junction were recruited. A variety of image postprocessing techniques including volume rendering (VR) and multiplanar reconstruction (MPR) were used to obtain aortic arch images. Multi-angle, multiplanar and multi-directional stereoscopic observation of the anatomy of the aortic arch and its major branches, analysis of the variation of aortic arch branch. Results Aortic arch was divided into two types: standard type and variant type. The most common type was standard type, accounting for 89.03% of the total number of cases. Variants accounted for 10.97% of the total number of cases. There were 4 different types of variation. The left common vertebral artery left aortic arch and located in the left common carotid artery (LCCA) and the left subclavian artery (LSA) accounted for 50% of patients with variant type, the total number of cases of 5.49 %; LCCA accounted for 38.46% of all cases of brachiocephalic trunk (BT), accounting for 4.22% of the total number of cases; LCCA originated from BT coexisting left vertebral artery from the aortic arch and located between LCCA and LSA Accounted for 7.69% of the total variance, accounting for 0.84% of the total number of cases; right aortic arch with vagal left subclavian accounted for 3.85% of the variant, 0.42% of the total number of cases. Conclusions Multi-slice spiral CTA can provide anatomic information for clinical variability of aortic arch.