Bradshaw K A, Pagano D, Bonser R S, McCafferty I, Guest P J
Department of Radiology, Queen Elizabeth Hospital, Birmingham, UK.
Clin Radiol. 1998 Mar;53(3):198-202. doi: 10.1016/s0009-9260(98)80100-1.
Conventional CT demonstrates pathology of the thoracic aorta. This study aimed to evaluate the additional contributions to surgical planning of multiplanar reformatting, maximum intensity projections and three-dimensional (3-D) reconstruction.
Retrospective. SUBJECT AND METHODOLOGY: Fifty-three patients with newly diagnosed pathology of the thoracic aorta were scanned over a 15-month period; 25 scans were spiral acquisitions. Scans were acquired during and following rapid injection of 100 ml of intravenous iopromide. The reconstructed data was displayed as axial images, oblique or other multiplanar reformats and shaded surface display 3-D reconstructions. Two radiologists and two surgeons reviewed the images. The axial images were assessed initially, subsequently the reformats and 3-D reconstructed views were examined looking particularly for additional information that might add to the surgical management.
Pathologies encountered were aortic dissection (21 patients, including two with Marfan's syndrome), saccular aneurysms (eight), fusiform aneurysms (16), aortic root and ascending aortic dilatation (seven) and coarctation (one). The relationship of aneurysms and dissections to major vessels are better shown with 3-D reconstruction or oblique reformats. Morphology of saccular aneurysms, particularly the neck, is well shown with 3-D reconstruction. Coarctation was best demonstrated by oblique reformats. There was little additional information from 3-D reconstruction or reformats in assessment of type A dissection. Improved spatial orientation by visualization in varying projections was helpful for surgical planning in certain cases of type B dissection, fusiform aneurysms and aortic root and ascending aortic root dilatation. Spiral acquisitions have the advantage of speed and hence a greater anatomical coverage for a single breath-hold.
Oblique reformats and 3-D reconstruction, although using identical data as the axial images, in specific cases were felt to aid surgical assessment of aneurysms and dissections, thus assisting pre-operative planning.
传统CT可显示胸主动脉的病变情况。本研究旨在评估多平面重组、最大密度投影及三维（3-D）重建对手术规划的额外贡献。
回顾性研究。
在15个月期间对53例新诊断为胸主动脉病变的患者进行扫描；其中25次扫描为螺旋采集。在快速静脉注射100ml碘普罗胺期间及之后进行扫描。重建数据以轴位图像、斜位或其他多平面重组图像以及表面阴影显示的3-D重建图像形式呈现。两名放射科医生和两名外科医生对图像进行了评估。首先评估轴位图像，随后检查重组图像和3-D重建视图，特别寻找可能有助于手术管理的额外信息。
所遇到的病变包括主动脉夹层（21例患者，其中2例患有马凡综合征）、囊状动脉瘤（8例）、梭形动脉瘤（16例）、主动脉根部及升主动脉扩张（7例）和主动脉缩窄（1例）。3-D重建或斜位重组能更好地显示动脉瘤和夹层与主要血管的关系。3-D重建能很好地显示囊状动脉瘤的形态，尤其是瘤颈。主动脉缩窄通过斜位重组显示最佳。在A型夹层的评估中，3-D重建或重组几乎没有提供额外信息。在某些B型夹层、梭形动脉瘤以及主动脉根部和升主动脉根部扩张的病例中，通过不同投影的可视化改善空间定位有助于手术规划。螺旋采集具有速度优势，因此在一次屏气时能获得更大的解剖覆盖范围。
尽管斜位重组和3-D重建使用与轴位图像相同的数据，但在特定情况下，它们有助于对动脉瘤和夹层进行手术评估，从而辅助术前规划。
