CAJ | 학술논문

目的探讨64层螺旋CT在脊髓血管介入术前评估中的价值.方法选择17例胸腰段脊髓损伤患者行脊柱64层螺旋CT增强扫描,重建薄层图像,层厚0.625 mm,间隔0.625 mm,以DICOM格式传输到ADW4.2工作站,采用容积显示(volume rendering,VR)、最大密度投影(maximum intensity projection,MIP)及多平面重建(multi-planar reformat,MPR)等后处理技术进行三维重建,分析脊髓供血动脉的走行特征.结果 17例患者中有16例患者(94%)胸腰段均可见根髓动脉供血脊髓,其中1支(6%)自T4/5左侧椎间孔进入椎管,2支(12%)自T10/11左侧椎间孔进入椎管,1支(6%)自T11/12左侧椎间孔进入椎管,4支(24%)根髓动脉自L1/2左侧椎间孔进入椎管,2支(12%)自L2/3左侧椎间孔进入椎管,2支(12%)自T11/12右侧椎间孔进入椎管,2支(12%)自T12/L1右侧椎间孔进入椎管,2支(12%)自L2/3右侧椎间孔进入椎管,10例(59%)患者根髓动脉自左侧椎间孔进入椎管.另有1例(6%)患者行CT和DSA检查均未发现根髓动脉.结论 64层螺旋CT能准确直观反映脊髓供血动脉的开口位置、走行方向、管径大小及其与周围血管的空间关系,为脊髓血管介入术前提供丰富的评估信息.
목적 탐토64층라선CT재척수혈관개입술전평고중적개치.방법 선택17례흉요단척수손상환자행척주64층라선CT증강소묘,중건박층도상,층후0.625 mm,간격0.625 mm,이DICOM격식전수도ADW4.2공작참,채용용적현시(volume rendering,VR)、최대밀도투영(maximum intensity projection,MIP)급다평면중건(multi-planar reformat,MPR)등후처리기술진행삼유중건,분석척수공혈동맥적주행특정.결과 17례환자중유16례환자(94%)흉요단균가견근수동맥공혈척수,기중1지(6%)자T4/5좌측추간공진입추관,2지(12%)자T10/11좌측추간공진입추관,1지(6%)자T11/12좌측추간공진입추관,4지(24%)근수동맥자L1/2좌측추간공진입추관,2지(12%)자L2/3좌측추간공진입추관,2지(12%)자T11/12우측추간공진입추관,2지(12%)자T12/L1우측추간공진입추관,2지(12%)자L2/3우측추간공진입추관,10례(59%)환자근수동맥자좌측추간공진입추관.령유1례(6%)환자행CT화DSA검사균미발현근수동맥.결론 64층라선CT능준학직관반영척수공혈동맥적개구위치、주행방향、관경대소급기여주위혈관적공간관계,위척수혈관개입술전제공봉부적평고신식.
Objective To investigate the value of 64-slice spiral computed tomography(CT)angiography in preoperative evaluation of spinal vascular intervention.Methods Seventeen patients with segmental injury of the spinal cord underwent the enhanced 64-slice CT scan of the spine.Thin-slice reconstruction was done,with the slice thickness of 0.625 mm and interval of 0.625 mm.The data were transferred to the work station ADW4.2 in DICM format.Image postprocessing technologies such as volume rendering(VR),maximum intensity projection(MIP)and multi-planar reformat(MPR)were used to conduct three-dimensional reconstruction and analyze the anatomical characteristics of radiculomedullary artery.Results Radiculomedullary artery could be found in the thoracolumbar segment of 16 patients(16/17,94%).Among them,one artery(1/17,6%)went into the vertebral canal through the left intervertebral foramen of T4/5,two(2/17,12%)through the left intervertebral foramen of T10/11,one (1/17,6%)through the left intervertebral foramen of T11/12,four(4/17,24%)through the left intervertebral foramen of L1/2,two(2/17,12%)through the left intervertebral foramen of L2/3,two (2/17,12%)through the right intervertebral foramen of T11/12,two(2/17,12%)through the right intervertebral foramen of T12/L1,two(2/17,12%)through the right foramen of L2/3 andl0(10/17,59%)through the left intervertebral foramen.Either CT scan or DSA examination found no radiculomedullary artery in one patient.All the above findings were in accordance with the results of DSA examination.Conclusions Spiral 64-slice CT scan can provide significant preoperative evaluation information for spinal vascular intervention,for it can accurately and visually show the anatomical features of the radiculomedullary artery such as open position,flow tendency,caliber size and spatial relationship with the surrounding vessels.