多層螺旋CT 血管成像在大動脈炎中的應用
馬祥興 張偉 馬曉峰 王青 于德新 李篤民 崔鳳玉 李傳福
【摘要】 目的 探討多層螺旋CT( MSCT) 血管成像在診斷大動脈炎中的臨床應用價值。方法
對臨床擬診大動脈炎的14 例患者進行MSCT 血管成像, 掃描范圍自頸2 椎體水平至恥骨聯合水平,
圖像后處理方法包括多平面重組、最大密度投影、容積重組、血管內鏡及血管分析, 充分顯示受累血管
的部位、范圍及程度。結果 14 例患者CT 表現為不同程度的動脈管壁增厚, 管腔狹窄或閉塞, 管腔
狹窄具有向心性的特點, 部分伴狹窄后擴張。按管腔情況包括狹窄-阻塞型8 例, 混合型6 例。重組
圖像結合軸面圖像觀察, 可以清晰顯示受累大血管及其分支血管的狹窄程度或閉塞情況以及側支血
管形成情況。依據Lupi-Herrea 分類法包括Ⅰ型5 例, Ⅱ型2 例, Ⅲ型6 例, Ⅳ 型1 例, CT 結果均與其
臨床表現相符。結論 MSCT 血管成像同時顯示大動脈炎的管腔情況和管壁改變, 后者對于早期診
斷及治療、改善預后具有重要意義, 可以作為此病的首選檢查方法。
【關鍵詞】 Takayasu 動脈炎; 體層攝影術, X 線計算機; 血管造影術
Multi-slice CT a ngiogra phy in the diagnosis of Takaya su′s art er itis MA Xia ng-xing , ZHANG Wei,
MA Xiao-feng, WANG Qing, YU De-xin, LI Du-min, CUI Feng-yu, LI Chuan-fu. The Imaging Center, Qilu
Hospital of Sha ndong University, J inan 250012, China
【Abstra ct 】 Objective To evaluate the clinical value of multi-slice CT ( MSCT) angiography in the
diagnosis of Takayasu′s arteritis. Methods Fourteen patients underwent MSCT angiography with use of
90 ml contrast media at a rate of 3. 5 ml / s. Images were generated for vascular assessment with various
reconstructional techniques , including multi-planar reformat ( MPR) , maximum intensity projection ( MIP) ,
volume rendering ( VR) , CT virtual endoscopy ( CTVE) and advanced vessel analysis ( AVA) . Results
MSCT angiography findings was consistent with the clinical changes of Takayasu′s arteritis in all cases. The
integrated information including reconstructional and transverse images clearly presented various luminal
abnormalities, such as stenosis , occlusion and dilatation in the affected aorta, as well as its major branches
and collateral circulation. Furthermore, it depicted mural abnormities, especially concentric arterial wall
thickening. Steno-occlusive type ( 8 /14) was more common than mixed type ( 6 /14) . According to Lupi-
Herrea′s classification, typeⅠ in 5 cases, type Ⅱ in 2, type Ⅲ in 6 and type Ⅳ in 1 were recorded in the
present study. Conclusion MSCT angiography is reliable imaging modality for the detection of Takayasu′s
arteritis. It is useful for early diagnosis because it allows evaluation of wall thickness rather than merely the
luminal diameter, which is especially important for prognosis. It might be used as the first choice in the
diagnosis of this disease as a simple, convenient and noninvasive method.
【Key wor ds】 Takayasu′s arteritis ; Tomography, X-ray computed; Angiography

多層螺旋CT 血管成像在大動脈炎中的應用--心血管.rar