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目的探讨16层CT多平面重建(MPR)与容积再现技术(VR)对主动脉夹层(AD)诊断的价值。方法经手术或DSA证实的AD患者43例,其中男性36例,女性7例;年龄29～78岁,平均年龄52.8岁。分析其16层CT征象,原始采集层厚为0.75mm,间隔0.75mm。MPR包括冠状位、矢状位和平行于主动脉弓的斜位,应用VR软件重建出立体三维图像。结果 43例患者中包括DeBakeyⅠ型13例,Ⅱ型2例,Ⅲ型28例(Ⅲa型11例,Ⅲb型17例)。Stanford分型法:A型15例,B型28例。MPR能直观显示夹层的整体形态、分支血管的走行及钙化,对夹层真假腔、内膜片和内膜初始破口的显示率高。VR立体感强,能清晰显示病变的全程及与分支血管的空间关系。结论充分应用16层CT的MPR和VR技术可以及早为AD患者做出正确的诊断,该技术应作为临床可疑患者的优选检查方法。
Objective To investigate the value of 16-slice CT multiplanar reconstruction (MPR) and volume rendering (VR) in the diagnosis of aortic dissection (AD). Methods 43 cases of AD patients confirmed by surgery or DSA, including 36 males and 7 females; aged 29 to 78 years, mean age 52.8 years. Analysis of 16-layer CT signs, the original acquisition layer thickness 0.75mm, interval 0.75mm. MPR including coronal, sagittal and oblique parallel to the aortic arch, using VR software to reconstruct a three-dimensional image. Results The 43 patients included 13 cases of DeBakey Ⅰ, 2 cases of type Ⅱ and 28 cases of type Ⅲ (11 cases of type Ⅲ a and 17 cases of type Ⅲ b). Stanford classification method: 15 cases of type A, B type 28 cases. MPR can visually show the overall shape of the dissection, the branch of the blood vessels and calcification, the true and false lumen of the dissection, endometrial and endometrial incipient rupture of the display rate. VR strong sense of three-dimensional, can clearly show the entire lesion and the branch of vascular space relationship. Conclusion MPR and VR, which fully utilize 16-slice CT, can diagnose AD patients as soon as possible. This technique should be used as the preferred method of examination for patients with suspected clinical diseases.