摘要
目的探讨64层螺旋CT肝脏多期血管成像不同后处理技术显示肝脏血管的能力及其临床应用价值。方法对209例肝脏多期增强扫描患者行肝动脉期、门静脉期双期血管成像,采用最大密度投影(MIP)、容积再现技术(VR)和多平面重组技术(MPR)三种重组方式,分析三种重组方法对肝动脉、门静脉系统、肝静脉以及肝肿瘤血管性病变的显示情况;同期30例患者行肝动脉DSA血管造影,并进行对照观察。结果本组肝动脉变异率为32%;VR与MIP对肝动脉2级以下分支及肿瘤供血动脉的显示无统计学意义(P>0.05),在显示3级以上肝动脉分支及肿瘤血管上有明显差异(P<0.05),MIP优于VR;30例同期行DSA检查的肝癌患者中,MIP与DSA在供血动脉及肿瘤血管的显示上完全一致,对3级以下肝动脉的显示无统计学意义,在4级以上肝动脉的显示上有差异(P<0.05),DSA优于MIP;VR与MIP在显示门静脉及肝静脉分支方面无统计学意义。门静脉有5种变异类型,变异率为27.8%。正常组肝静脉Ⅰ型80例(95%),Ⅱ型4例(5%),7例(8.3%)可见右后下肝静脉。结论64层螺旋CT肝血管成像能更准确、全方位地显示肝血管、肝血管性病变及富血管性肿瘤性病变,可为外科手术及介入术前提供准确信息。VR、MIP与MPR三种重组技术结合使用在肝血管性病变的诊断方面并不亚于DSA。
Objective To evaluate the capability of 64-slice spiral CT in displaying hepatic vessels, its clinical value and compare the difference between different postprocessing technique in liver multi-phase angiography. Methods Two hundreds and nine patients who underwent multiphase enhanced liver scan involved in this study. Maximum intensity projection （MIP）, volume rendering （VR） and multiple planar reformation （MPR） were used to reconstruct liver vessel three-dimensionally in arterial phase and portal-vein phase. The demonstration of hepaticartery, portal vein, hepatic vein and vascular changes in hepatic tumor were analyzed and compared with each other. Thirty cases were performed hepatic arterial DSA at the same time and used as reference. Results The variant rate in this group was up to 32%. No significant difference was found between VR and MIP in displaying hepatic artery branches under grade 2 and tumor feeding artery, however, MIP is better than VR in demonstrating hepatic artery branches smaller than grade 3 and tumor vascular changes with great significance （P〈0. 05）. Of the 30 patients with hepatic tumor underwent DSA examination at the same time, MSCTA had the same ability as DSA in displaying feeding artery and no significant difference was found in displaying hepatic artery under grade 3, but DSA is better than MSCTA in displaying hepatic artery smaller than grade 4 with great significance （P〈0.05） .No significant difference was found between VR and MIP. Portal vein had five sorts of variant, variant rate was 27.8%. There are two types of hepatic vein in 84 cases enrolled in this study, among which type I accounted for 95 % （80 cases） and type Ⅱ5% （4 cases）, and right posterior segment of hepatic vein can be displayed in 7 cases, exhibition rate were 8. 3%. Conclusion 64-slice spiral CTA can display hepatic vessels and vascular changes more accurately and especially in the demonstration of tiny hepatic vessel. This technique can provide accurate information before surgery and intervention. A combination of different postprocessing techniques such as VR, MIP and MPR could as good as DSA.
出处
《中国医学影像技术》
CSCD
北大核心
2007年第12期1838-1843,共6页
Chinese Journal of Medical Imaging Technology
