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目的探讨16层CT血管成像3种重组技术:最大密度投影(M IP)、薄层最大密度投影(TSM IP)和容积重组(VR)对胰腺供血动脉的显示率,比较显示胰腺供血动脉的优势。方法40例非胰腺病变的患者行腹部16层CT增强扫描和动脉期血管成像。统计TSM IP、M IP及VR对胰腺直接、间接供血动脉的显示率及显示状况。用配对χ2检验观察显示率的差异;用配对秩和检验观察显示状况的差异。结果(1)3种重组技术对胰腺间接供血动脉的显示率均为100%(40/40)。TSM IP、M IP、VR对胰十二指肠上后动脉(PSPDA)的显示率分别为92.5%(37/40)、77.5%(31/40)、67.5%(27/40);对胰十二指肠上前动脉(ASPDA)的显示率分别为95.0%(38/40)、82.5%(33/40)、75.0%(30/40);对胰十二指肠下动脉(IPDA)的显示率分别为92.5%(37/40)、75.0%(30/40)、57.5%(23/40)。(2)TSM IP与VR对ASPDA、PSPDA、IPDA的显示率的差异有统计学意义(χ2值分别为6.27、7.81、13.07、P值均<0.01);TSM IP与M IP对IPDA的显示率差异有统计学意义(χ2值为4.50,P<0.05)。(3)TSM IP与M IP对胃十二指肠动脉(Z=-3.317,P=0.001)、胃左动脉(Z=-3.557,P=0.000)、肝固有动脉(Z=-2.810,P=0.005)、ASPDA(Z=-4.796,P=0.000)、PSPDA(Z=-4.400,P=0.000)和IPDA(Z=-4.811,P=0.000)的显示状况的差异有统计学意义;TSM IP与VR对胃十二指肠动脉(Z=-3.162,P=0.003)、胃左动脉(Z=-3.051,P=0.002)、肝固有动脉(Z=-2.460,P=0.014)、ASPDA(Z=-5.166,P=0.000)、PSPDA(Z=-5.056,P=0.000)和IPDA(Z=-5.564,P=0.000)的显示状况的差异有统计学意义;M IP与VR对ASPDA(Z=-3.000,P=0.002)、PSPDA(Z=-2.352,P=0.019)和IPDA(Z=-3.500,P=0.000)显示状况的差异有统计学意义。结论TSM IP显示胃左动脉、肝固有动脉、胃十二指肠动脉和胰腺直接供血动脉优于M IP及VR。M IP显示胰腺直接供血动脉优于VR。
Objective To explore the advantages of three reconstruction techniques of 16-slice CT angiography: the maximum density projection (M IP), the maximum density projection (TSM IP) and the volumetric reorganization (VR) on the rate of pancreas feeding arteries . Methods Forty patients with non-pancreatic lesions underwent 16-slice CT enhancement and arterial phase angiography. Statistics TSM IP, M IP and VR of pancreatic direct and indirect supply artery display rate and display status. The paired χ2 test was used to observe the difference in display rates; the paired rank sum test was used to show the difference in status. Results (1) All the three kinds of recombinant techniques showed 100% (40/40) visualization of the indirect pancreatic artery. The positive rates of PSPDA in TSM IP, M IP and VR were 92.5% (37/40), 77.5% (31/40) and 67.5% (27/40) respectively. The positive rates of ASPDA were 95.0% (38/40), 82.5% (33/40) and 75.0% (30/40), respectively. The positive rate of pancreaticoduodeneal artery (IPDA) The display rates were 92.5% (37/40), 75.0% (30/40) and 57.5% (23/40) respectively. (2) There was significant difference in the display rates of ASPDA, PSPDA and IPDA between TSM IP and VR (χ2 = 6.27, 7.81, 13.07, P <0.01) The difference was statistically significant (χ2 = 4.50, P <0.05). (3) TSM IP and M IP showed no significant difference between the gastric duodenal artery (Z = -3.317, P = 0.001), left gastric artery (Z = -3.557, P = 0.000), hepatic artery (Z = -2.810, P = 0.005), ASPDA (Z = -4.796, P = 0.000), PSPDA (Z = -4.400, P = 0.000) and IPDA IP and VR had no significant effect on the rate of gastroduodenal artery (Z = -3.162, P = 0.003), left gastric artery (Z = -3.051, P = 0.002), hepatic artery (Z = -2.460, P = 0.014) There were significant differences in the display status of PSPDA (Z = -5.166, P = 0.000) and IPDA (Z = -5.564, P = 0.000) (Z = -3.000, P = 0.002), PSPDA (Z = -2.352, P = 0.019) and IPDA (Z = -3.500, P = 0.000) showed statistical significance. Conclusions TSM IP shows that the left gastric artery, hepatic artery, gastroduodenal artery and pancreatic artery are better than M IP and VR. M IP showed that the pancreatic direct feeding artery was superior to VR.