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目的比较64排CT血管造影(MDCTA)的多种图像后处理重建技术显示各型主动脉瘤形态特征的能力。方法回顾性分析手术确诊的主动脉瘤患者65例的MDCTA资料,所有原始图像均行多平面重建(MPR)、曲面和管腔拉直图(CPR和LS)、最大密度投影(MIP)、表面遮盖(SSD)、CT内窥镜(CTVE)、容积再现(VR)重建,统计并比较每种重建图像中可以显示的与主动脉瘤诊治密切相关的图像特征。结果在主动脉瘤65例中,真性动脉瘤14例,假性动脉瘤13例,夹层动脉瘤38例,后者DebakeyⅠ型18例,Ⅱ型3例,Ⅲ型17例(Ⅲa型8例,Ⅲb型9例),与手术结果一致。VR及CPR和LS重建图像能最佳显示真性和假性动脉瘤的形态特征;CPR和LS,CTVE,VR对于显示夹层动脉瘤的形态特征最好;轴位图像对各类动脉瘤都具有重要价值。不同重建图像显示各型动脉瘤的形态特征不同,多种图像结合可以更准确的显示病变特征。结论MDCTA的多种图像后处理重建技术可准确诊断主动脉瘤并显示各型动脉瘤的形态特征;任何类型的动脉瘤的诊断都需以轴位原始图像为依据,同时结合重建图像最优显示其形态学特点。
Objective To compare the ability of various post-operative reconstruction techniques of 64-slice CT angiography (MDCTA) to show the morphological features of various types of aortic aneurysms. Methods The data of MDCTA in 65 patients with aortic aneurysm confirmed by surgery were retrospectively analyzed. All the original images were examined by MPR, CPR and LS, MIP, (SSD), CT endoscopy (CTVE) and volumetric reconstruction (VR). Statistics and comparison of the image features that are closely related to the diagnosis and treatment of aortic aneurysm can be made in each reconstruction image. Results Among the 65 cases of aortic aneurysm, 14 cases were true aneurysm, 13 cases were pseudoaneurysm and 38 cases were dissection aneurysm. The latter 18 cases were Debakey type Ⅰ, 3 cases type Ⅱ and 17 cases Ⅲ type (8 cases of type Ⅲ a, Ⅲ b type 9 cases), consistent with the surgical results. VR and CPR and LS reconstruction images can best show the morphological features of true and false aneurysms; CPR and LS, CTVE, VR showed the best morphological characteristics of dissecting aneurysms; axial images of all types of aneurysms are important value. Different reconstruction images show different types of aneurysm morphological characteristics, a variety of images combined with more accurate display of lesion characteristics. Conclusion A variety of image reconstruction techniques of MDCTA can accurately diagnose aortic aneurysms and show the morphological features of various types of aneurysms. The diagnosis of any type of aneurysms requires axial original images as the basis, combined with reconstruction of optimal images Its morphological characteristics.