摘要
目的研究采用能谱CT最佳单能量成像以及选择前臂皮下静脉作为监测点行上肢血管全景成像的方法,并探讨其评价自体动静脉内瘘功能不良的应用价值。方法入组53例自体动静脉内瘘功能不良患者,采用前臂皮下静脉血管作为监测点的技术改良方法行能谱CT扫描,获得最佳单能量薄层图像,采用多平面重建(MPR)、容积再现(VR)等后处理方法进行图像重建,放射科和肾脏内科医师共同阅片,绘制血管通路示意图。结果所有患者获得可用于诊断的图像,主观评价优良48例,合格5例,差0例;经三维重建技术清晰显示血管通路全景,显示输入动脉段狭窄1例,动脉血栓形成5例,动脉瘤瘤体2例;瘘口狭窄22例,血栓形成5例;前臂段引流静脉血栓形成31例,瘤样扩张19例,侧支循环形成5例,皮下血肿1例;上臂段静脉狭窄1例,血栓形成6例;中心静脉狭窄6例,血栓形成2例。结论能谱CT上肢血管全景成像技术方法可行,评估自体动静脉内瘘功能不良可靠、准确,具有无创、清晰、全景、直观等优点,对治疗方案有重要的参考价值。
Objective To explore the best single-energy imaging of spectral CT and the selection of forearm subcutaneous vein as a monitoring point for panoramic imaging of upper extremity blood vessels,and explore its application value in evaluating autologous arteriovenous fistula dysfunction.Methods A total of 53 patients with autologous arteriovenous fistula dysfunction were enrolled,and the forearm subcutaneous venous blood vessels were used as a monitoring point to perform an energy spectral CT scan to obtain the best single-energy thin-layer image.The images were processed by post-processing methods such as MPR and VR Reconstruction,radiology and nephrologists read the film together,and draw a schematic diagram of vascular access.Results All patients obtained images that can be used for diagnosis.Subjective evaluation was excellent in 48 cases,qualified in 5 cases,and poor in 0 cases.Three-dimensional reconstruction technology clearly displayed the panoramic view of the vascular pathway,showing 1 case of narrowing of the arterial segment,5 cases of arterial thrombosis,2 cases of aneurysms;22 cases of fistula stenosis,5 cases of thrombosis;31 cases of forearm drainage venous thrombosis,19 cases of tumor-like dilatation,5 cases of collateral circulation formation,1 case of subcutaneous hematoma;1 case of upper arm vein stenosis,thrombus 6 cases were formed;6 cases had central vein stenosis,and 2 cases had thrombosis.Conclusion Energy spectral CT imaging of upper limb vascular panoramic imaging is feasible,and the assessment of autologous arteriovenous fistula dysfunction is reliable and accurate.It has the advantages of non-invasive,clear,panoramic and intuitive.
作者
姚标
李曾
贾超
黄肖肖
石岩
Yao Biao;Li Ceng;Jia Chao;Huang Xiaoxiao;Shi Yan(Department of Radiology,Xuzhou Hospital Affiliated of Jiangsu University,Xuzhou Cancer Hospital,Jiangsu 221005,China)
出处
《实用医学影像杂志》
2020年第6期582-585,共4页
Journal of Practical Medical Imaging
基金
江苏大学医学临床科技发展基金(JLY20160071)。
