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目的:探讨多层螺旋CT血管造影不同重建方法在主动脉瘤腔内隔绝术后的临床应用价值。材料和方法:46例主动脉瘤腔内隔绝术后行多层螺旋CT血管造影,采用准直2.5mm,层厚3.0mm,螺距为6,重建方法为容积显示技术(volume rendering,VR)、表面阴影遮盖显示(shade surface display,SSD)及最大密度投影法(maximumintensity proection,MIP),并对三种方法进行比较。结果:46例中有1例术后内支架出现局限性断裂,VR及MIP均清晰显示了内支架的变化,SSD未能显示。1例内支架展开不良,三种重建方法均明确显示;6例术后出现渗漏,VR清晰显示渗漏的部位、形态及内漏量,MIP、SSD仅显示其中的5例,三者中以VR显示最佳。在显示支架内血流情况及瘤周血栓方面,VR能明确支架内有无血栓形成及腔内隔绝术后的转归变化,VR显示1例术后支架内血栓形成SSD及MIP未能显示。结论:多层螺旋CT能在较短时间内进行大范围的扫描,有利于主动脉病变的检查:VR图像优于SSD及MIP,能为术后内支架情况提供更多更准确的信息,VR技术应作为主动脉瘤内支架术后的首选三维重建方法。
Objective: To investigate the clinical value of different reconstruction methods of multi-slice spiral CT angiography after endovascular exclusion of aortic aneurysm. MATERIALS AND METHODS: 46 cases of aortic aneurysm were treated with endovascular graft exclusion. Multi-slice spiral CT angiography was performed with a 2.5mm alignment, a 3.0mm slice thickness and a pitch of 6. The reconstruction method was volume rendering (VR) The shaded surface display (SSD) and the maximum intensity projection (MIP) were compared and the three methods were compared. RESULTS: One of the 46 patients had a localized rupture of the endoluminal stent. VR and MIP clearly showed the change of the stent. The SSD failed to show the result. 1 case of stent unfavorable, three kinds of reconstruction methods are clearly shown; 6 cases of postoperative leakage, VR clearly shows the site of leakage, shape and leakage, MIP, SSD showed only 5 of them, three The best VR display. In displaying stent blood flow and peritumor thrombosis, VR can determine the presence or absence of thrombosis in the stent and the outcome after endovascular graft exclusion. VR shows that stent thrombosis SSD and MIP failed to show in 1 case. CONCLUSIONS: MSCT can scan a wide range in a short period of time, which is good for the examination of aortic lesions. VR images are better than SSD and MIP, which can provide more and more accurate information for the postoperative stent. VR Technology should be used as aortic aneurysm stenting after the preferred three-dimensional reconstruction method.