多层螺旋CT在烟雾病诊断中的应用
Application of Multi-slice Spiral CT in the Diagnosis of Moyamoya Disease
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摘要: <b<目的</b< 探讨16排螺旋CT血管造影(MSCTA)及其重建在烟雾病诊断与治疗中的应用价值。 <b<材料与方法</b< 分析15例烟雾病病例。受检者均行颅脑CT平扫和MSCTA检查。在ADW4.2工作站上作容积再现(VR)、最大密度投影(MIP)和多平面重建(MPR)。 <b<结果</b< 多层螺旋CT血管造影均清晰显示发生狭窄、闭塞的颈内动脉、Wills环血管近侧端以及明显增多、扩张的脑底部侧支血管影,其中双侧颈内动脉闭塞6例,单侧颈内动脉伴同侧大脑后动脉狭窄1例,单侧大脑中动脉8例,其中1例同时动脉瘤。所有CTA图像均可评价侧支血管情况,表现为相应血管及其分支的粗大、增多、迂曲延长。VR重建图像有利于显示狭窄段与周围骨性结构空间关系,但在显示、评价脑底增生小血管和侧支血管方面不及MIP和MPR重建。 <b<结论</b< 综合运用多种重建技术,多层螺旋CT血管造影不仅可以清晰显示狭窄血管,还可以评价狭窄远端血管和侧支血管等情况,直观显示病变周围空间结构关系,从而为治疗提供重要的参考依据。Abstract: <b<Objective</b< To evaluate the value of 16-slice Spiral CT angiography(M empirical study of SCTA) and reconstruction in the diagnosis and therapy of moyamoya disease. <b<Material and methods</b< 15 patiants with moyamoya disease were examined both with routine CT scanning and MSCTA,all performed Volume Rending(VR)、Maximum density projection(MIP) and Multiplanar reconstruction(MPR) with ADW4.2 software. <b<Results</b< In all cases CTA showed the stenosis or obstruction of arteria carotis interna(ICA) or proximum of Wills circle,abnormal vessel network in brain basal part.Including stenosis of bilateral ICA(6cases),one side ICA and posterior cerebral artery(1 case),one side middle cerebral artery(8 cases).The branch vessels could been evaluated with CTA images.VR was better on showing the stenosis of the vessels and its spatial relation with surrounding bone structure,MIP and MPR was better on showing abnormal vessel network in brain basal part and branch vessels. <b<Conclusion</b< With different reconstruction,MSCTA can display the abnormal vessels and spatial relation very well,and provide important reference for the therapy.
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