CTA多期动态重建显示腹主动脉夹层内膜搏动的应用价值

doi:10.6040/j.issn.1671-7554.0.2015.1164

山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (3): 50-54.doi: 10.6040/j.issn.1671-7554.0.2015.1164

CTA多期动态重建显示腹主动脉夹层内膜搏动的应用价值

刘文¹,王锡明²,段艳华²,杨世锋³,纪晓鹏³,康瑞⁴

1. 泰山医学院研究生部, 山东泰安 271016;2.山东省医学影像学研究所, 山东济南 250021;3. 山东大学附属省立医院医学影像科, 山东济南 250021;4.山东大学医学院, 山东济南 250012

收稿日期:2015-11-25 出版日期:2016-03-10 发布日期:2016-03-10
通讯作者: 王锡明. E-mail:wxming369@163.com E-mail:wxming369@163.com
基金资助:
国家自然科学基金(81371547);山东省自然科学基金(ZR2012HM006);山东省科技发展计划项目(2014GSF118103);泰山学者工程专项经费

The value of multiphase dynamic reconstruction with CTA to the intimal flap motion of abdominal aortic dissection

LIU Wen¹, WANG Ximing², DUAN Yanhua², YANG Shifeng³, JI Xiaopeng³, KANG Rui⁴

1. Taishan Medical University, Taian 271016, Shandong, China;
2. Shandong Medical Imaging Research Institute, Jinan 250021, Shandong, China;
3. Department of Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China;
4. School of Medicine, Shandong University, Jinan 250012, Shandong, China

Received:2015-11-25 Online:2016-03-10 Published:2016-03-10

摘要/Abstract

摘要： 目的探讨低剂量回顾性心电门控CTA多期相动态重建对显示腹主动脉夹层内膜搏动的应用价值。方法腹主动脉夹层患者30例行光子CT低剂量回顾性心电门控扫描,从0%~95%R-R间期每隔5%进行图像重建,测量20期图像中腹腔干、肠系膜上动脉、左右肾动脉根部水平真腔短轴直径和相应水平腹主动脉直径,计算两者比值(d_-T/d_-AA)、真腔/腹主动脉(d_-T/d_-AA)的最大值、最小值和位于70%R-R间期时两者的比值;比较三者之间有无差异,间接找出评价内膜搏动范围。结果腹腔干、肠系膜上动脉水平内膜搏动范围较大,在70%R-R、d_-T/d_-AA的最大值、最小值之间均有明显变化,左右肾动脉水平内膜在d_-T/d_-AA最大值与最小值期相之间搏动明显,在70%R-R与d_-T/d_-AA最大、最小值期相之间搏动弱,变化不明显。有效辐射剂量(16.1±2.19)mSv。结论低剂量回顾性心电门控CTA多期动态重建能良好地显示腹主动脉夹层内膜搏动的情况。

关键词: 动态重建, 内膜搏动, 腹主动脉夹层, 回顾性心电门控CTA

Abstract: Objective To explore the value of low dose of multiphase dynamic reconstruction using retrospective ECG gated CTA to the intimal flap motion of abdominal aortic dissection. Methods Thirty patients with abdominal aortic dissection underwent with retrospective ECG gated double source CT(DSCT), and 20 datasets were reconstructed in 5% steps between 0 and 95% of the R-R interval in each case. The short axis diameter of the true lumen and abdominal aorta in the level of the root of celiac and superior mesenteric artery, left renal artery and right renal artery in each phase were measured, and the ratio of both(d_-T/d_-AA)was calculated. The ratio of the minimum and maximum as well as 70% R-R intervals was calculated and the three statistical difference for evaluating the intimal flap indirectly was compared. Results The scope of intimal flap was strong in the level of celiac and superior mesenteric artery, and intimal flap was significantly changed between 70% R-R, the maximum and the minimum. Intimal flap was significantly changed between the maximum and minimum in the level of right renal artery and left renal artery. The scope of intimal 山东大学学报 (医学版)54卷3期 -刘文,等.CTA多期动态重建显示腹主动脉夹层内膜搏动的应用价值 \=-flap was weak between 70% R-R and the maximum as well as between 70% R-R and the minimum. The changes was not obvious. Conclusion Low dose of multiphase dynamic reconstruction using retrospective ECG gated CTA can show the intimal flap motion of abdominal aortic dissection.

Key words: Dynamic reconstruction, Intimal flap, Abdominal aortic dissection, Retrospective ECG-gated CTA

中图分类号:

R445.3

刘文,王锡明,段艳华,杨世锋,纪晓鹏,康瑞. CTA多期动态重建显示腹主动脉夹层内膜搏动的应用价值[J]. 山东大学学报（医学版）, 2016, 54(3): 50-54.

LIU Wen, WANG Ximing, DUAN Yanhua, YANG Shifeng, JI Xiaopeng, KANG Rui. The value of multiphase dynamic reconstruction with CTA to the intimal flap motion of abdominal aortic dissection[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(3): 50-54.

参考文献

[1] McMahon MA, Squirrell CA. Multidetector CT of aortic dissection: a pictorial review[J]. Radiographics, 2010, 30(2):445-460.
[2] 陈水龙,郑剑涛,江宏飞,等. 主动脉夹层院内死亡相关危险因素分析[J]. 中国循证心血管医学杂志,2015,7(2):262-264. CHEN Shuilong, ZHENG Jiantao, JIANG Hongfei, et al. Relative risk factors of in-hospital death due to aortic dissection[J]. Chin J Evid Based Cardiovasc Med, 2015, 7(2):262-264.
[3] Smith AD, Schoenhagen P. CT imaging for acute aortic syndrome [J]. Cleve Clin J Med, 2008, 75(1): 7-9, 12, 15-17.
[4] Nagamine H, Ueno Y, Ueda H, et al. A new classification system for branch artery perfusion patterns in acute aortic dissection for examining the effects of central aortic repair[J]. Eur J Cardiothorac Surg, 2013, 44(1):146-153.
[5] Yang S, Li X, Chao B, et al. Abdominal aortic intimal flap motion characterization in acute aortic dissection: assessed with retrospective ECG-gated thoracoabdominal aorta dual-source CT angiography [J]. PLoS One, 2014, 9(2):87664
[6] Meredith EL, Masani ND. Echocardiography in the emergency assessment of acute aortic syndromes[J]. Eur J Echocardiogr, 2009, 10(1):31-39.
[7] B(¨overo)rner N, Erbel R, Braun B, et al. Diagnosis of aortic dissection by trans-esophageal echocardiography[J]. Am J Cardiol, 1984, 54(8):1157-1158.
[8] 印隆林,杨志刚,陈加源,等. 主动脉夹层的临床病理特点及CT诊断[J].中国医学影像技术, 2010,26(7):1373-1375. YIN Longlin, YANG Zhigang, CHEN Jiayuan, et al. Clinicopathological features and CT diagnosis of aortic dissection[J] , Chin J Med Imaging Technol, 2010, 26(7):1373-1375.
[9] 刘一,晏子旭,吴晓峰,等. 螺距的选择对胸腹主动脉夹层320层CT成像质量的影响[J]. 放射学实践,2011,26(3):350-353. LIU Yi, YAN Zhixu, WU Xiaofeng, et al. Effect of different pitch on image quality and radiation dose in aortic CT angiography with 320-slice CT[J]. Radiol Practice, 2011, 26(3):350-353.
[10] 翟鸣春,王永梅.双源CT主动脉夹层扫描方案探讨[J]. 国际医学放射学杂志,2013,3(36):210-213. ZHAI Mingchun, WANG Yongmei. Scanning protocol of dual-source computed tomography for aortic dissection[J]. Int J Med Radiol, 2013, 3(36):210-213.
[11] 陈亮,杨剑,刘金成,等. 双源CT术前评估胸主动脉夹层破口的对照研究[J]. 第四军医大学学报,2009,30(10):953-956. CHEN Liang, YANG Jian, LIU Jincheng, et al. Dual-source CT for tears of thoracic aortic disse-ctions assessment:a controlled trial[J].J Fourth Mil Med Univ, 2009, 30(10):953-956.
[12] 林少帆,吴先衡,林黛英,等. 多层螺旋CT血管成像在评估主动脉夹层内膜破口中的应用研究[J]. 实用医技杂志,2013,20(4):363-365. LIN Shaofan, WU Xianheng, LIN Daiying, et al. The study of multi-slice computed tomography on the evaluation of the intimal tear of aortic dissection[J]. Journal of Practical Medical Techniques, 2013, 20(4):363-365.
[13] Cui Y, Zhang H, Gong GX, et al.Charactetization of aortic dissection as pulsating type and static stype during cardiac cycle by electrocardiogram-gated dual-source CT[J].Int of Cardiao, 2015, 15(185):236-239.
[14] Krissak R, Henzler T, Prechel A, et al. Triplerule-out dualsource CT angiography of patients with acute chest pain: dose reduction potential of 100 kV scanning[J]. Eur J Radiol, 2012, 81(12):3691-3696.
[15] Li Y, Fan Z, Xu L, et al. Prospective ECG-gated 320-row CT angiography of the whole aorta and coronary arteries[J]. Eur Radiol, 2012, 22(11):2432-2440.

相关文章 13

[1]	李媛媛,王锡明,王龙,纪淙山,段艳华,程召平,刘燕萍,陈静. 双源CT Flash扫描在心血管源性气道狭窄患儿诊断中的临床应用[J]. 山东大学学报（医学版）, 2017, 55(11): 59-64.
[2]	李进叶,宋歌声,宋吉清,王大伟,靳先文,张成琪. 宝石能谱CT与常规超声对甲状腺结节良恶性诊断价值的对照分析[J]. 山东大学学报（医学版）, 2016, 54(3): 81-86.
[3]	李笃民,王茜,李传福,王青. 合并Whipple三联征的多发性内分泌腺瘤1型——附2例报道[J]. 山东大学学报（医学版）, 2016, 54(1): 62-66.
[4]	谢超贤, 龙腾河, 廖明壮. MSCT在主动脉壁间血肿和穿透性动脉硬化性溃疡的诊断价值[J]. 山东大学学报（医学版）, 2014, 52(S2): 123-125.
[5]	赵春龙, 于文东, 胡万朝. 高分辨64排螺旋CT对早期矽肺的诊断价值[J]. 山东大学学报（医学版）, 2014, 52(Z1): 148-148.
[6]	于澜1，谷海燕2，牛蕾1，隋庆兰1. 肾上腺皮质嗜酸细胞腺瘤合并高血压1例[J]. 山东大学学报(医学版), 2013, 51(10): 110-112.
[7]	张敬东，马祥兴. 孤立性肺结节与支气管关系的多层螺旋CT及病理对照研究[J]. 山东大学学报(医学版), 2010, 48(8): 91-95.
[8]	崔谊1，何敬振1，王磊2，王青1，侯金文1，马祥兴1. 成人肠系膜上动脉主干及邻近结构多层螺旋CT三维解剖学研究[J]. 山东大学学报(医学版), 2010, 48(8): 96-99.
[9]	韩雪，王青，崔凤玉. MSCTA在活体肾移植供肾切除术前的应用[J]. 山东大学学报(医学版), 2010, 48(4): 102-105.
[10]	. SWI显示弥漫性轴索损伤病灶个数与GCS评分相关性的分析[J]. 山东大学学报(医学版), 2009, 47(10): 126-129.
[11]	丁霞赵斌马子堂贾守勤. 肝门静脉系统栓塞的机制探讨[J]. 山东大学学报(医学版), 2009, 47(5): 106-108.
[12]	甘洁,刘平,王营,祝军,步春青,李大华,魏巍巍,李斌 . 利用MSCT评价冠状动脉粥样硬化斑块与急性冠脉综合征的相关性[J]. 山东大学学报(医学版), 2008, 46(1): 91-93.
[13]	边致强,刘亚群,李笃民,崔凤玉. 多层螺旋CT对婴幼儿先天性感音性耳聋的诊断价值[J]. 山东大学学报(医学版), 2007, 45(12): 1257-1260.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed

CTA多期动态重建显示腹主动脉夹层内膜搏动的应用价值

The value of multiphase dynamic reconstruction with CTA to the intimal flap motion of abdominal aortic dissection

PDF (PC)

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 13

多维度评价

本文评价

推荐阅读 0