摘要
目的利用多层螺旋CT血管造影(multi-slice spiral CT agiography,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。方法对152例临床怀疑椎动脉病变的患者行16层螺旋CT血管造影术(CTA)检查,然后应用容积重建(VR)、最大密度投影(MIP)、多平面重建(MPR)及曲面重建(CR)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、软斑块、钙化斑块、管腔闭塞和起源变异等7种常见病变的发病部位、原因以及各种成像技术的发现率。结果 152例患者304条椎动脉,共发现椎动脉迂曲96条;椎动脉变细52条;管腔局限性狭窄30条,其中24条(80%)为粥样硬化斑块所致,5条(16.7%)为骨质压迫所致,15条(50.0%)发生在椎前部,6条(20.0%)发生在横突部,9条(30.0%)发生在颅内部;管壁软斑块17条,全部为MPR和曲面重建观察到;管壁钙化斑块10条,MPR和MIP发现10条,曲面重建发现8条,透明化VR发现0条;管腔闭塞7条,均发生在椎前部;起源变异5条,均为左侧椎动脉直接起源于主动脉弓。结论 MSCTA对椎动脉常见病变的诊断具有重要的价值,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 observe the pathological changes in vertebral artery by using multi-slice spiral CT angiography（ MSCTA） and investigate the diseased sites,causes and imaging features as well as compare the advantage and disadvantage of three types of 3D reconstruction techniques for displaying the pathological changes. Methods One hundred and fifty-two patients with clinical suspicion of vertebral artery disease were examined with MSCTA. Afterwards,the vertebral arteries were observed by several 3-D reconstruction techniques such as volume rendering（ VR）,multiple plannar reformation（ MIP）,multiple plannar reformation（ MPR）and curvedreformation（ CR）. The diseased sites and causes of 7 types of common pathological changes such as circuity,thinning,stenosis,soft plaque,calcified plaque,obstruction and source variation were statistically analyzed. The discover rates of these changes among various image techniques were also compared. Results Of 304 arteries in the 152 patients,96 arteries were found circuity,52 arteries were found thinning and 30 arteries were found stenosis. Of the 30 stenosal arteries,24 arteries（ 80. 0%） were caused by scleratheroma plaques and 5 arteries（ 16. 7%） were caused by bone oppression. Further,there were 15 arteries（ 50. 0%） occurred on the anteriorvertebral section,6 arteries（ 20. 0%） occurred on the transverse process section and 9 arteries（ 30. 0%） occurred on the intracranial section. Seventeen arteries were found soft plaque that was discovered by MPR and CR. Ten arteries were found calcified plaques in which 10 arteries could be discovered by MPR and MIP,8 arteries by CR,and no artery by hyalinize volume rendering（ h VR）. Seven arteries were found obstruction that all occurred on the re-vertebral section. Five arteries were found source variation that all were the left vertebral artery directly coming from aortic arch. Conclusion MSCTA has important value in diagnosis of usual pathological changes in vertebral artery. Each 3-D reconstruction
出处
《实用医院临床杂志》
2015年第2期69-72,共4页
Practical Journal of Clinical Medicine
关键词
椎动脉
颈椎病
体层摄影术
X射线计算机
后处理
Vertebral artery
Cervical spondylosis
Tomography
X-ray computed
Post processing
