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目的评价多层螺旋CT血管造影技术在胸部大血管急诊病例诊断中的临床应用价值。方法25例胸部大血管急症病例行多层螺旋CT血管造影检查,结合二维和三维重建技术进行图像分析。结果中央型肺栓塞10例,夹层动脉瘤12例,动脉瘤2例,多发大动脉炎合并肾动脉狭窄1例。二维图像(多平面容积重建及曲面重建)较好显示病变范围、大小及病变细节,而三维重建(最大密度投影、表面遮盖成像和容积重建)良好显示管壁钙化情况和病变空间关系。仿真内窥镜可以判断肺动脉内栓子与血管壁关系、显示夹层动脉瘤的内膜破口情况、内膜片与血管关系。结论多层螺旋CT血管造影结合影像后处理技术是一种有效的诊断胸部大血管急诊的检查方法。
Objective To evaluate the clinical value of multislice spiral CT angiography in the diagnosis of thoracic major vascular emergencies. Methods Twenty-five cases of thoracic vascular emergency were examined by multi-slice spiral CT angiography. Two-dimensional and three-dimensional reconstruction techniques were used for image analysis. Results Central pulmonary embolism in 10 cases, 12 cases of dissecting aneurysm, aneurysm in 2 cases, multiple arteritis with renal artery stenosis in 1 case. Two-dimensional images (multiplanar volume reconstruction and surface reconstruction) are good indicators of lesion size, size and lesion detail, while 3D reconstruction (maximal density projection, surface occlusion imaging and volume reconstruction) is a good indicator of wall calcification and lesion spatial relationships. Emulation endoscopy can determine pulmonary embolism and vascular wall relationship, showing the dissection of dissection aneurysm, endometrial vessels and vascular relationship. Conclusion Multi-slice spiral CT angiography combined with image post-processing technique is an effective method to diagnose major thoracic vascular disease.