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目的探讨16层螺旋CT肝脏多期血管成像方法及其临床价值。方法对70例肝脏多期增强扫描患者,行肝动脉期、门静脉期双期血管成像,采用最大密度投影(MIP)、容积再现技术(VRT)、表面遮盖显示(SSD)重建技术,分析三种重建方法对肝动脉、门静脉系统以及肝肿瘤血管性病变(HTVPC)显示情况。结果肝动脉期CT血管造影术(CTA)对二级肝动脉、三级分支以下肝动脉、肿瘤供血动脉及肿瘤血管的显示率分别约90%、69%、90%、69%。MIP与VRT对二级肝动脉分支及肿瘤供血动脉显示的差异无统计学意义(P>0.05),对三级以下肝动脉分支及肿瘤血管的显示有显著性差异(P<0.05),以MIP显示率为高。门静脉期CTA可显示正常肝内门静脉5~6级分支。肝癌肝动脉-门静脉瘘发生率约13.9%,门静脉癌栓发生率约58%,以MIP显示最佳。结论16层螺旋CT肝血管成像是了解肝动脉、门静脉系统状况及肝肿瘤血管性病变的无创性血管成像技术,以MIP及VRT价值较大,可为外科手术及介入术前提供重要信息及指导作用。
Objective To investigate the multi-slice spiral CT angiography and its clinical value in 16-slice spiral CT. Methods Totally 70 patients with multi-phase contrast-enhanced liver biopsy underwent hepatic arterial and portal venous phase angiography. The maximum density projection (MIP), volumetric reconstruction (VRT) and surface reconstruction (SSD) Reconstruction of the hepatic artery, portal vein system and liver tumor vascular lesions (HTVPC) showed the situation. Results Hepatic arterial phase CT angiography (CTA) showed about 90%, 69%, 90% and 69% of the rate of the secondary hepatic artery, the hepatic artery below the tertiary branches, the tumor feeding artery and the tumor vessels respectively. There was no significant difference between MIP and VRT on the level of secondary hepatic artery branches and tumor feeding artery (P> 0.05). There was significant difference between the three branches of hepatic artery and tumor vessels (P <0.05) Display rate is high. Portal venous phase CTA can show normal intrahepatic portal vein grade 5 to 6 branches. HCC hepatic artery - portal vein fistula incidence of about 13.9%, portal vein tumor thrombus incidence of about 58%, MIP showed the best. Conclusions 16-slice spiral CT hepatic angiography is a noninvasive vascular imaging technique to understand the hepatic artery, portal system and hepatic tumor. It is of great value to MIP and VRT to provide important information and guidance before surgery and intervention effect.