Lu Dong, Li Cheng-Li, Lv Wei-Fu, Ni Ming, Deng Ke-Xue, Zhou Chun-Ze, Xiao Jing-Kun, Zhang Zhen-Feng, Zhang Xing-Ming
Department of Interventional MRI, Shandong Provincial Medical Imaging Research Institute, Shandong University, Jinan, Shandong 250021, P.R. China; Department of Radiology, Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei, Anhui 230001, P.R. China.
Department of Interventional MRI, Shandong Provincial Medical Imaging Research Institute, Shandong University, Jinan, Shandong 250021, P.R. China.
Exp Ther Med. 2017 Feb;13(2):405-412. doi: 10.3892/etm.2016.3985. Epub 2016 Dec 19.
The aim of the present study was to compare multislice computed tomography angiography (MSCTA) and digital subtraction angiography (DSA) in the diagnosis of aortic dissection. In total, 49 patients with aortic lesions received enhanced computed tomography scanning, and three-dimensional (3D) images were reconstructed by volume rendering (VR), maximum intensity projection (MIP), multiplanar reformation (MPR) and curved planar reconstruction (CPR). The display rate of the entry tear site, intimal flap, true and false lumen from each reconstruction method was calculated. For 30 patients with DeBakey type III aortic dissection, the entry tear site and size of the first intimal flap, aortic maximum diameter at the orifice of left subclavian artery (LSCA), distance between the first entry tear site and the orifice of LSCA, and maximum diameter of aortic true and false lumens were measured prior to implantation of endovascular covered stent-grafts. Data obtained by MSCTA and DSA were then compared. For the entry tear site, MPR, CPR and VR provided a display rate of 95.92, 95.92 and 18.37%, respectively, and the display rate of the intimal flap was 100% in the three methods. MIP did not directly display the entry tear site and intimal flap. For true and false lumens, MPR, CPR, and VR showed a display rate of 100%, while MIP only provided a display rate of 67.35%. When MSCTA was compared with DSA, there was a significant difference in the display of entry site number and position (P<0.05), whereas no significant difference was shown in the measurement of aortic maximum diameter at the orifice of LSCA and the maximum diameter of true and false lumens (P>0.05). In conclusion, among the 3D post-processing reconstruction methods of MSCTA used, MPR and CPR were optimal, followed by VR, and MIP. MSCTA may be the preferable imaging method to diagnose aortic dissection and evaluate treatment of endovascular-covered stent-grafting, preoperatively.
本研究的目的是比较多层螺旋计算机断层血管造影（MSCTA）和数字减影血管造影（DSA）在主动脉夹层诊断中的应用。共有49例主动脉病变患者接受了增强计算机断层扫描，并通过容积再现（VR）、最大密度投影（MIP）、多平面重建（MPR）和曲面重建（CPR）重建了三维（3D）图像。计算每种重建方法对破口部位、内膜瓣、真假腔的显示率。对30例DeBakey III型主动脉夹层患者，在植入血管腔内覆膜支架移植物前，测量破口部位及首个内膜瓣大小、左锁骨下动脉（LSCA）开口处主动脉最大直径、首个破口部位与LSCA开口之间的距离以及主动脉真假腔最大直径。然后比较MSCTA和DSA获得的数据。对于破口部位，MPR、CPR和VR的显示率分别为95.92%、95.92%和18.37%，三种方法中内膜瓣的显示率均为100%。MIP未直接显示破口部位和内膜瓣。对于真假腔，MPR、CPR和VR的显示率为100%，而MIP仅为67.35%。当将MSCTA与DSA比较时，破口部位数量和位置的显示存在显著差异（P<0.05），而在LSCA开口处主动脉最大直径和真假腔最大直径的测量中无显著差异（P>0.05）。总之，在MSCTA的3D后处理重建方法中，MPR和CPR最佳，其次是VR，MIP最差。MSCTA可能是术前诊断主动脉夹层和评估血管腔内覆膜支架植入治疗的首选成像方法。
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