CAJ | 학술논문

目的探讨综合应用CT血管造影(CTA)多种重建方法对腹主动脉瘤(AAA)腔内隔绝术术前影像学评估的价值.方法回顾分析2009年6月至2011年3月共100例AAA多排螺旋CT血管造影(MSCTA)资料,并分析其中83例成功实施主动脉腔内修复术(EVAR)患者的MSCTA影像学资料,应用容积再现(VRT)、多平面重建(MPR)最大密度投影(MIP)和曲面重建(CPR)分别测量EVAR术相关各解剖学数据,并对照单纯应用轴位影像数据测最,比较各测量值之间的差异.结果 15例(15.0％)行外科腹主动脉人工血管置换术,2例(2.0％)临床定期随诊,未行手术治疗,83例(83.0％)行EVAR术治疗.行EVAR术治疗的83例患者中,Ⅰ型仅2例(2.4％);Ⅱ型66例(79.5％),其中Ⅱa型35例、Ⅱb型18例、Ⅱc型13例;Ⅲ型15例(18.1％).对比83例行EVAR术病例的MSCTA不同重建方法与轴位测量间数据,近端瘤颈长度、瘤体长度、髂总动脉长度,远端瘤颈长度、近端瘤颈内径、远端瘤颈内径、髂总动脉内径等各测量值差异分析显示差异存在着显著性,单纯应用轴位成像测量,会高估血管内径线,而对长度测量则会导致低估.结论单纯应用轴位影像或仅根据DSA测量数值均会导致较大的测量误差,尤其对长度测量.应综合应用MSCTA多种重建方法直观显示AAA的形态学变异、腔内精确结构及分支血管关系,精确测量AAA与治疗相关的主要径线,为临床治疗方法的选择提供有力依据.
목적 탐토종합응용CT혈관조영(CTA)다충중건방법대복주동맥류(AAA)강내격절술술전영상학평고적개치.방법 회고분석2009년6월지2011년3월공100례AAA다배라선CT혈관조영(MSCTA)자료,병분석기중83례성공실시주동맥강내수복술(EVAR)환자적MSCTA영상학자료,응용용적재현(VRT)、다평면중건(MPR)최대밀도투영(MIP)화곡면중건(CPR)분별측량EVAR술상관각해부학수거,병대조단순응용축위영상수거측최,비교각측량치지간적차이.결과 15례(15.0％)행외과복주동맥인공혈관치환술,2례(2.0％)림상정기수진,미행수술치료,83례(83.0％)행EVAR술치료.행EVAR술치료적83례환자중,Ⅰ형부2례(2.4％);Ⅱ형66례(79.5％),기중Ⅱa형35례、Ⅱb형18례、Ⅱc형13례;Ⅲ형15례(18.1％).대비83례행EVAR술병례적MSCTA불동중건방법여축위측량간수거,근단류경장도、류체장도、가총동맥장도,원단류경장도、근단류경내경、원단류경내경、가총동맥내경등각측량치차이분석현시차이존재착현저성,단순응용축위성상측량,회고고혈관내경선,이대장도측량칙회도치저고.결론 단순응용축위영상혹부근거DSA측량수치균회도치교대적측량오차,우기대장도측량.응종합응용MSCTA다충중건방법직관현시AAA적형태학변이、강내정학결구급분지혈관관계,정학측량AAA여치료상관적주요경선,위림상치료방법적선택제공유력의거.
Objective To assess the clinical value of integrated applications of multi slice computer tomography angiography(MSCTA) and multiple reconstruction methods in pre-operative abdominal aortic aneurysms.Methods The MSCTA data of 100 abdominal aortic aneurysms(AAA) from June 2009 to March 2011 were analyzed retrospectively.And the parameters that endovascular aortic repair(EVAR) required were measured by volume rendering techique( VRT),mulit-planar reformation( MPR),maximum intensity projection(MIR) and curved planar reformation(CPR) reconstruction seperately in 83 cases which had underwent EVAR successfully.Compared with single axis view of measurements,the differences between MSCTA different reconstruction methods were assessed.Results Traditional surgeries were performed in 15 cases,clinical follow up were performed in 2 cases,and EVAR were performed in 83 cases.In 83 cases which underwent EVAR,2 cases were type Ⅰ (2/83,2.4％ ),66 cases were type Ⅱ ( 66/83,79.5 ％ ),in which 35 cases were type Ⅱ a,18 cases were type Ⅱ b,13 cases were type Ⅱ c,and 15 cases were type Ⅲ ( 15/83,18.1％ ).The parameters including the length and diameter of proximal and distal neck,the bilateral common iliac arteries,the diameter of bilateral external iliac arteries,the length of aneurysm,and the angles were measured in MSCTA.Compared with the single axis view of measurements,there was significance differences.Conclusions The abdominal aortic aneurysm measured by single axis view can lead to an error measurements of length.The integrated applications of MSCTA and multiple reconstruction methods can describe the details of AAA.