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目的探讨64层CTA在腹部中小血管肿瘤侵犯程度判断中的应用价值。方法应用64层螺旋CT机,在进行腹部增强扫描检查的患者中,收集经手术或穿刺病理证实的腹部肿瘤25例,其中胰腺癌9例,肝癌8例,其他腹腔恶性肿瘤8例。采用动脉、门脉期双期扫描方式,应用容积再现(VR)、最大密度投影(MIP)及多平面重建(MPR)技术进行动脉、门脉期血管三维重建,总结以上各相关血管的CTA表现并分类统计,在各类CTA表现的血管中,分别随机选取血管3支,应用血管探针(VP)技术显示,分析征象表现。结果当肿瘤与血管有脂肪间隙或凸面接触时,本组血管均表现管壁规则、管腔无狭窄(48支)。肿瘤与血管为凹面接触或部分包绕时,动脉多表现管壁规则、管腔无狭窄(11/11支),而静脉则较多见管壁不规则,管腔狭窄(3/11支)。肿瘤完全包绕血管时,动脉表现为管壁规则、管腔正常的6支,血管狭窄,管壁不规则7支,但无1例见肿物侵入管腔内。静脉被完全包绕时则多见肿物破坏管腔,向内侵犯甚至闭塞(10/16支)。VP表现与VR、MIP、MPR等较一致。结论64层CTA多种成像方式充分显示肿瘤与血管的毗邻、接触面、包绕程度等相互关系,并清晰反映管壁的形态、管腔改变及血管阻塞等情况。
Objective To investigate the value of 64-slice CTA in judging the degree of invasion of small and medium-sized blood vessels in the abdomen. Methods Twenty-five cases of abdominal tumors confirmed by surgery or biopsy were collected from patients undergoing abdominal enhanced scanning. Among them, 9 cases of pancreatic cancer, 8 cases of liver cancer and 8 cases of other malignant tumors of the abdominal cavity. The arterial and portal venous phase three-dimensional reconstruction was performed by arterial and portal venous double-phase scanning using VR, MIP and MPR techniques, and the CTA findings of the above related vessels were summarized According to the classification statistics, three blood vessels were randomly selected from the blood vessels of various types of CTA, and the signs of the signs were analyzed by using the vascular probe (VP) technique. Results When the tumor and vascular fat gap or convex contact, the group of vessels showed rules of the wall, the lumen without stenosis (48). When the tumor is in concave contact with the blood vessel or is partly surrounded by the artery, the artery often shows the rule of the vessel wall without stenosis (11/11), while the vein is more common with irregular wall and stenosis (3/11) . When the tumor completely surrounds the blood vessel, the artery manifests as rule of vessel wall, normal lumen of 6, stenosis of blood vessel, and irregular wall of tube 7, but none of the tumor intrudes into the lumen. When the vein is completely surrounded by the tumor is more common destruction of the lumen, inward invasion or occlusion (10/16). VP performance and VR, MIP, MPR more consistent. Conclusion The multi-slice 64-slice CTA imaging method fully shows the relationship between the adjacent tumor, the contact surface and the degree of surrounding the tumor, and clearly reflects the shape of the wall, the lumen changes and the vascular occlusion.