Stallard D J, Tu R K, Gould M J, Pozniak M A, Pettersen J C
Department of Radiology, University of Wisconsin Hospital and Clinics, Madison 53792-3252.
Radiographics. 1994 May;14(3):493-513. doi: 10.1148/radiographics.14.3.8066265.
With the early generations of computed tomographic (CT) scanners, interpretation of abdominal and pelvic scans focused on the solid organs, hollow viscera, and retroperitoneum. Attention to blood vessels generally was given only to the aorta and inferior vena cava and their larger branches. The newer generations of scanners allow rapid acquisition of high-resolution images during the vascular phase of mechanical bolus injection of intravenous contrast material. Visualization of second-order vascular branches has thus become routine. Recent improvements in software allow real-time reconstruction of data in multiple planes, which enables demonstration of long segments of vessels within a single image. Approximately 7,000 abdominal and pelvic CT scans were reviewed with attention to vascular detail. Cases are presented that illustrate peripancreatic, perigastric, parietal, and hypogastric vessels; fetal remnants and structures that may be mistaken for vessels; and collateral pathways of both arterial and venous flow. With increasing use of helical CT scanning, smaller vessels can be identified with greater confidence. Knowledge of normal CT vascular anatomy facilitates understanding of collateral pathways when vessel engorgement is perceived.
早期的计算机断层扫描(CT)扫描仪对腹部和盆腔扫描的解读主要集中在实体器官、中空脏器和腹膜后间隙。对血管的关注通常仅局限于主动脉、下腔静脉及其较大分支。新一代扫描仪能够在经静脉机械推注造影剂的血管期快速采集高分辨率图像。因此,二级血管分支的显影已成为常规操作。软件方面的最新进展允许在多个平面实时重建数据,从而能够在单幅图像中展示长段血管。我们回顾了约7000例腹部和盆腔CT扫描,重点关注血管细节。本文展示了一些病例,这些病例说明了胰周、胃周、壁层和下腹血管;可能被误认为血管的胎儿残余和结构;以及动静脉血流的侧支循环途径。随着螺旋CT扫描的使用日益增多,更小的血管也能更有把握地被识别出来。了解正常的CT血管解剖结构有助于在察觉到血管充血时理解侧支循环途径。