摘要
目的:探讨多层螺旋CT血管造影(CTA)技术在肝总动脉变异患者中的诊断效能及影像学特点。方法:选择2019年12月-2020年12月佳木斯大学附属第一医院收治的疑似肝总动脉变异患者300例作为研究对象,所有患者均行肝脏256层螺旋CTA检查,并将诊断获得的数据、影像资料传输到后处理软件中,完成容积再现(VR)、最大密度投影(MIP)及多平面重组(MPR)重建等,观察肝动脉、分支的解剖变异情况,分析其影像学表现,将检查结果与数字减影血管造影(DSA)检查结果(金标准)进行比较,并完成图像质量分析。结果:300例患者DSA检查确诊47例,检出率为15.67%;肝脏256层螺旋CTA检出患者肝总动脉变异45例,检查准确率为98.00%,与金标准比较,差异无统计学意义(P>0.05);诊断敏感度为91.49%,特异度为99.21%;阳性预测值为95.56%,阴性预测值为98.43%。两种检查方法对肠系膜上动脉、腹主动脉、胃左动脉及其他内脏动脉分支检出率比较,差异均无统计学意义(P>0.05);256层螺旋CTA确诊的45例肝总动脉变异患者中变异类型前三位分别为Ⅰ、Ⅱ及Ⅲ型,分别占71.11%、6.67%和6.67%;256层螺旋CTA在肝总动脉变异中图像优良率高于DSA检查(P<0.05)。结论:256层螺旋CTA检查用于肝总动脉变异中能获得较高的检出率,能准确地判断肝动脉及分支解剖变异情况,图像质量相对清晰,可为临床诊疗提供影像学依据,值得推广应用。
Objective:To investigate the diagnostic efficiency and imaging characteristics of multi-slice spiral CT angiography (CTA) in patients with common hepatic artery variation.Method:A total of 300 patients with suspected common hepatic artery variation in Jiamusi University Affiliated First Hospital from December 2019 to December 2020 were selected as the research objects.All patients underwent 256-slice spiral CTA examination of liver.The data obtained from diagnosis and image data were transmitted to the post-processing software to complete volume reproduction (VR),maximum density projection (MIP) and multiplanar reconstruction (MPR).The anatomical variation of hepatic artery and branches was observed,the imaging manifestations was analyzed,the results were compared with the results of digital subtraction angiography (DSA) (gold standard),and the image quality analysis was completed.Result:In 300 patients,47 cases were diagnosed by DSA,and the detection rate was 15.67%;45 cases of common hepatic artery variation were detected by 256-slice spiral CTA,and the accuracy rate was 98.00%,compared with the gold standard,the difference was not statistically significant (P>0.05);the diagnostic sensitivity was 91.49%,and the specificity was 99.21%;the positive predictive value was 95.56%,and the negative predictive value was 98.43%.There were no significant differences in the detection rates of superior mesenteric artery,abdominal aorta,left gastric artery and other visceral artery branches between the two methods (P>0.05);among 45 patients with common hepatic artery variation diagnosed by 256-slice spiral CTA,the first three types of variation were type Ⅰ,Ⅱ and Ⅲ,accounting for 71.11%,6.67% and 6.67% respectively;the excellent and good rate of 256-slice spiral CTA in common hepatic artery variation was higher than that of DSA (P<0.05).Conclusion:256-slice spiral CTA can obtain a high detection rate in the variation of common hepatic artery,accurately judge the anatomical variation of hepatic artery and branches,and th
作者
邓静
徐鹏
DENG Jing;XU Peng(Jiamusi University Affiliated First Hospital,Jiamusi 154000,China;不详)
出处
《中国医学创新》
CAS
2022年第15期127-131,共5页
Medical Innovation of China
关键词
256层螺旋CT
血管造影技术
肝总动脉变异
影像表现
256-slice spiral CT
Angiography technique
Common hepatic artery variation
Imaging manifestation
