摘要
目的利用多层螺旋CT血管造影(multi-slice spiral CTangiography,MSCTA)观察椎动脉的常见病变,探讨其发病部位、原因及CTA表现,并比较几种常见三维后处理技术对椎动脉病变显示的优缺点。方法128例临床怀疑有椎动脉病变的病人,其中男性72例,女性56例,年龄35～82岁,平均年龄58.5岁。临床表现为发作性头昏、眩晕者92例,头痛者79例,颈部疼痛者55例,上肢麻木者23例,听力减退者9例,视力减退者7例,有高血压动脉硬化病史者75例。行16层螺旋CTA检查,然后应用容积重建(volume rendering,VR)、透明化容积重建(hyalinize volume rendering,hVR)、最大密度投影(maximun intensity projection,MIP)和曲面重建(curved planar reformation,CPR)等三维后处理技术对椎动脉进行观察,统计分析椎动脉迂曲、管腔变细、管腔局限性狭窄、非钙化斑块、钙化斑块、管腔闭塞、动脉瘤和起源变异等8种常见病变的发病部位、原因及各种成像技术的发现率。其中27例在CTA检查后2周内行DSA检查。结果128例病人,256条椎动脉,共发现椎动脉迂曲80条;椎动脉变细42条;管腔局限性狭窄28条,其中23条(82.1%)为粥样硬化斑块所致,5条(17.9%)为骨质压迫所致,14条(50.0%)发生在椎前部,5条(17.9%)发生在横突部,9条(32.1%)发生在颅内部;管壁非钙化斑块15条,曲面重建观察到14条;管壁钙化斑块8条,均被MIP和曲面重建发现,透明化VR发现0条;管腔闭塞5条,均发生在椎前部;椎动脉瘤3条,均发生在颅内部;起源变异4条,均为左侧椎动脉直接起源于主动脉弓。27例(54条椎动脉)既行CTA又行DSA检查的对照分析显示,CTA对椎动脉狭窄的敏感度为81.3%,特异度为94.7%,准确度为90.7%。结论多层螺旋CT血管造影对椎动脉常见病变的诊断具有重要价值,各种后处理方法对不同病变的显示各有优缺点,宜结合观察。
Objective To investigate the genetic locus,causes and imaging features of common pathological changes of vertebral artery by means of multi-slice spiral CT angiography（MSCTA）,and compare the advantage and disadvantage of three 3-D reconstruction techniques for displaying the pathological changes of vertebral artery.Methods All 128 patients suspected as vertebral artery disorders were performed MSCTA.And the vertebral arteries were observed by several 3-D reconstruction techniques ig.VR（volume rendering）,hVR（hyalinize volume rendering）,MIP（multiple planar reformation） and CPR（curved planar reformation）.The pathological changes of vertebral arteries ig.circuity,thinning,stenosis,noncalcified plaque,calcified plaque,obstruction,vertebral aneurysm and original variation were analysed and which incidence rates in five 3-D reconstruction images were statistically analyzed.Twenty-seven patients received DSA examination in 2 weeks after CTA.Results Of 256 arteries in 126 patients,80 arteries were found circuity;42 arteries were found thinning;28 arteries were found stenosis,in which 23 arteries（82.1 %） were caused by scleratheroma plaque and 5 arteries（17.9 %） were caused by bone oppression,and disorders in 14 arteries（50.0 %） occured on anterior-vertebral section,5 arteries（17.9 %） occured on transverse process section,9 arteries（32.1 %） occurred on intracranial section.In contrast analysis both CTA and DSA were performed in 27 patients the coincidence rate of vertebral stenosis with CTA in sensitivity,specificity,and accuracy was 81.3 %,94.7 % and 90.7 % respectively.Conclusion It is demonstrated that various post processing techniques have their own advantages and disadvantages for different vertebral disorders.Thus comprehensive observation for disorders is appropriate in diagnosis.
出处
《生物医学工程与临床》
CAS
2007年第5期367-372,共6页
Biomedical Engineering and Clinical Medicine
关键词
椎动脉
颈椎病
体层摄影术
X线计算机
后处理
vertebral artery
cervical spondylosis
tomography,X-ray computed
post processing
