中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
11期
1284-1286
,共3页
黄小勇%黄连军%濮欣%窦瑞雨%李杰%薛玉国
黃小勇%黃連軍%濮訢%竇瑞雨%李傑%薛玉國
황소용%황련군%복흔%두서우%리걸%설옥국
主动脉瘤%腹部%腔内隔绝术%CT血管造影%测量
主動脈瘤%腹部%腔內隔絕術%CT血管造影%測量
주동맥류%복부%강내격절술%CT혈관조영%측량
Aortic aneursysm%Abodomine%Endovascular%Computer tomographyangiography%Measuring
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)腔内隔绝术术前腹主动脉瘤测量影像学评估的价值.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、多平面重建、最大密度投影和曲面重建分别测量EVAR术相关各解剖学数据,并对照单纯应用轴位影像数据测量,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有统计学意义.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,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.
目的 探討綜閤應用CT血管造影(CTA)多種重建方法對腹主動脈瘤(AAA)腔內隔絕術術前腹主動脈瘤測量影像學評估的價值.方法 迴顧分析2009年6月至2011年3月共100例AAA多排螺鏇CT血管造影(MSCTA)資料,併分析其中83例成功實施主動脈腔內脩複術(EVAR)患者的MSCTA影像學資料,應用容積再現、多平麵重建、最大密度投影和麯麵重建分彆測量EVAR術相關各解剖學數據,併對照單純應用軸位影像數據測量,比較各測量值之間的差異.結果 15例(15.0%)行外科腹主動脈人工血管置換術,2例(2.0%)臨床定期隨診,未行手術治療,83例(83.0%)行EVAR術治療.行EVAR術治療的83例患者中,Ⅰ型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%).對比83例行EVAR術病例的MSCTA不同重建方法與軸位測量間數據,近耑瘤頸長度、瘤體長度、髂總動脈長度,遠耑瘤頸長度、近耑瘤頸內徑、遠耑瘤頸內徑、髂總動脈內徑等各測量值差異有統計學意義.單純應用軸位成像測量,會高估血管內徑線,而對長度測量則會導緻低估.結論 單純應用軸位影像或僅根據DSA測量數值均會導緻較大的測量誤差,應綜閤應用MSCTA多種重建方法直觀顯示AAA的形態學變異、腔內精確結構及分支血管關繫,精確測量AAA與治療相關的主要徑線,為臨床治療方法的選擇提供有力依據.
목적 탐토종합응용CT혈관조영(CTA)다충중건방법대복주동맥류(AAA)강내격절술술전복주동맥류측량영상학평고적개치.방법 회고분석2009년6월지2011년3월공100례AAA다배라선CT혈관조영(MSCTA)자료,병분석기중83례성공실시주동맥강내수복술(EVAR)환자적MSCTA영상학자료,응용용적재현、다평면중건、최대밀도투영화곡면중건분별측량EVAR술상관각해부학수거,병대조단순응용축위영상수거측량,비교각측량치지간적차이.결과 15례(15.0%)행외과복주동맥인공혈관치환술,2례(2.0%)림상정기수진,미행수술치료,83례(83.0%)행EVAR술치료.행EVAR술치료적83례환자중,Ⅰ형2례(2.4%);Ⅱ형66례(79.5%),기중Ⅱa형35례、Ⅱb형18례、Ⅱc형13례;Ⅲ형15례(18.1%).대비83례행EVAR술병례적MSCTA불동중건방법여축위측량간수거,근단류경장도、류체장도、가총동맥장도,원단류경장도、근단류경내경、원단류경내경、가총동맥내경등각측량치차이유통계학의의.단순응용축위성상측량,회고고혈관내경선,이대장도측량칙회도치저고.결론 단순응용축위영상혹부근거DSA측량수치균회도치교대적측량오차,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,mulit-planar reformation,maximum intensity projection and curved planar reformation 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 (2.4%),66 cases were type Ⅱ (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 ( 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.