Kanematsu M, Imaeda T, Mizuno S, Yamawaki Y, Sone Y, Iida T, Kato M, Yokoyama R
Department of Radiology, Gifu University School of Medicine, Japan.
AJR Am J Roentgenol. 1996 Mar;166(3):585-91. doi: 10.2214/ajr.166.3.8623632.
The aim of this study was to compare with conventional angiography images the diagnostic utility of three-dimensional CT hepatic angiography (CTHA) images reconstructed from spiral CT images obtained during direct injection of contrast material into hepatic arteries.
Three-dimensional CTHA images were reconstructed from spiral CTHA images obtained during direct hepatic arterial contrast material injection in 22 patients. We used maximum-intensity-projection (MIP) and shaded-surface-display (SSD) techniques. We compared matched pairs of MIP CTHA images and SSD CTHA images with conventional angiograms for depiction of peripheral (segmental to subsegmental order branches) and proximal (common to proper) hepatic arteries as well as for conspicuity of the entire hepatic arterial tree in 22 patients and for conspicuity of tumors, recognition of tumor sites, and depiction of tumor-feeding arteries in 21 patients with malignant liver tumors. Our evaluations were performed in a blinded fashion by two experienced radiologists, who reached a consensus. (These radiologists also counted the number of tumors depicted by each method in the 21 patients with malignant liver tumors.)
Depiction of peripheral and proximal hepatic arteries and conspicuity of the entire hepatic arterial tree were significantly better on conventional angiograms than on MIP CTHA images and SSD CTHA images. Conspicuity of tumors and recognition of tumor sites were significantly better on MIP CTHA images and SSD CTHA images than on conventional angiograms. Depiction of tumor-feeding arteries was significantly better on MIP CTHA images than on SSD CTHA images and conventional angiograms. For 47 malignant liver tumors, MIP CTHA images showed 40 (85%), SSD CTHA images showed 34 (72%), and conventional angiograms showed 20 (43%).
MIP CTHA images showed liver tumors, tumor sites, and tumor-feeding arteries better than conventional angiograms. MIP was the preferred method for three-dimensional CTHA analysis.
本研究旨在将经肝动脉直接注射造影剂时获取的螺旋CT图像重建的三维CT肝血管造影（CTHA）图像与传统血管造影图像的诊断效用进行比较。
对22例患者经肝动脉直接注射造影剂时获取的螺旋CTHA图像进行三维重建。采用最大密度投影（MIP）和表面阴影显示（SSD）技术。将22例患者的MIP CTHA图像和SSD CTHA图像与传统血管造影图像进行配对比较，以显示外周（节段至亚节段级分支）和近端（肝总动脉至肝固有动脉）肝动脉，以及显示22例患者的整个肝动脉树的清晰度，和21例肝恶性肿瘤患者的肿瘤清晰度、肿瘤部位识别及肿瘤供血动脉显示情况。由两名经验丰富的放射科医生以盲法进行评估并达成共识。（这些放射科医生还统计了21例肝恶性肿瘤患者中每种方法显示的肿瘤数量。）
传统血管造影在外周和近端肝动脉的显示以及整个肝动脉树的清晰度方面明显优于MIP CTHA图像和SSD CTHA图像。MIP CTHA图像和SSD CTHA图像在肿瘤清晰度和肿瘤部位识别方面明显优于传统血管造影。MIP CTHA图像在肿瘤供血动脉显示方面明显优于SSD CTHA图像和传统血管造影。对于47个肝恶性肿瘤，MIP CTHA图像显示40个（85%），SSD CTHA图像显示34个（72%），传统血管造影显示20个（43%）。
MIP CTHA图像在肝肿瘤、肿瘤部位及肿瘤供血动脉显示方面优于传统血管造影。MIP是三维CTHA分析的首选方法。
