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收稿日期:2008206226　修回日期:2008209221

医学影像学

CT 血管造影技术的临床应用现状和进展

尹　东,李宏宇

(广西壮族自治区人民医院骨科,南宁530021)

中图分类号:R814.42 文献标识码:A 文章编号:100622084(2008)2123315204

基金项目:广西壮族自治区卫生厅医药卫生基金(Z2008071) 摘要:CT 血管造影已经成为诊断血管疾病的重要方法之一,在临床上主要用于诊治脑血管

疾病(特别是脑动脉瘤)、冠状动脉疾病、外周血管疾病等。在肿瘤的诊断和术前评估方面有初步

应用。随着CT 设备和技术的进步和发展,以及对CT 血管造影技术认识的提高,其临床应用的范

围正逐步扩大。本文就CT 血管造影技术的临床应用现状和进展予以综述。

关键词:体层摄影术,X 线计算机;血管造影;血管疾病;肿瘤;三维重建C li n i ca l Appli ca ti on and Progress on Techn i que of Com puted Tom ography Ang i ography YI N

D ong,L I Hong 2yu .(O rthopeadic D epart m ent,Guangxi Zhuang Autono m ous R egion Hospital,N anning

530021,China )

Abstract:Computed t omography angi ography is one of the most i m portant techniques in diagnosis of vascular diseases,es pecially in the diagnosis and treat m ent of intracranial aneurys m s,cor onary arterial and extre m ity arterial diseases .Preli m inary app licati on of computed t omography angi ography has been used in diagnosis and p re 2operative evaluati on of s ome kinds of tumors such asmuscul oskeletal tumors .I n this arti 2

cle,we described recent clinical app licati on and p r ogress in computed t omography angi ography .

Key words:Tomography,X 2ray computed;Angi ography;Vascular diseases;Tumor;Three di m en 2si onal reconstructi on

CT 血管造影(computed t omography angi ography,

CT A )又称螺旋CT A 、三维CT A,已经成为诊断血管

疾病的重要方法之一,尤其在心、脑血管系统疾病方

面应用比较广泛,在临床上主要用于诊治脑血管疾

病(特别是脑动脉瘤)、冠状动脉疾病、外周血管疾病

等[123]。在肿瘤的应用方面,目前局限于颅底、肾、胰

等高血供肿瘤[426]

。随着CT 设备和技术的进步和发展,以

及对CT A 技术认识的提高,在临床的应用范围正逐步扩大。

1　CTA 在颅内血管的应用CT A 一般不诱发颅内出血,较脑血管造影安全。主要应用在以下方面:①动脉瘤。CT A 越来越多地作为筛选动脉瘤的首选方法[7]

。对于怀疑动脉瘤的蛛网膜下腔出血

的患者,CT A 是及早获得诊断的安全有效方法。CT A 可以显示各型动脉瘤,包括梭形动脉瘤;还能够准确的显示动脉瘤和瘤颈的形状、瘤顶的方向及动脉瘤与周围骨结构(如前床突)的关系,并可以测量动脉瘤和瘤颈的大小,有时还可显示动脉瘤的破口,甚至模拟手术入路。Taschner 等[8]用数字减影血管造影(digital subtracti on angi ography,DS A )作对照,发现

CT A 诊断动脉瘤的敏感度为100%,特异度为83%,