【摘要】 目的 评估256层CT血管造影显示脊髓Adamkiewicz动脉(AKA)的可行性。方法 120例受试者接受256层CT血管成像,按照造影剂注射速率随机分成3组,4ml/s组、5 mL/s组和6 mL/s组,每组按照触发阈值200 HU和350 HU再分成2小组,每小组20例受试者。应用自动触发技术,达到阈值后延迟4s开始扫描,所有CTA均由256层CT扫描机扫描,造影剂使用2 mL/kg,碘含量350mg I/mL,通过18G留置套管针肘前静脉注射,对原始数据进行容积重建(VR),多平面重建(MPR),最大密度投影(MIP)和曲面重建(CPR),由2位心血管影像诊断医师对结果进行分析。诊断标准:AKA在斜冠状位出现特征性的发夹征(hairpin sign),同时在血管CPR、MIP和VR显示AKA和主动脉之间的连续性确认。结果 4mL/s200 HU组确认7例,350 HU组6例;5 mL/s 200 HU组确认11例,350 HU组10例;6 mL/s、200 HU组确认19例,350 HU组确认18例,3组间AKA确认率有明显的统计学差异(P<0.01)。结论 在6 mL/s注射速率和200 HU及350 HU触发阈值扫描条件下,256层CT脊髓血管造影能够精确显示AKA和相应的节段性动脉,为临床提供可靠信息。更多还原

【Abstract】 Objective To evaluate the value of 256-detector CT angiography(CTA) in depicting Adamkiewicz artery(AKA) of spinal cord.Methods 120 patients without vascular diseases underwent 256-detector CTA.All cases were divided into three groups according to injecting speed of contrast medium,4mL/s,5 mL/s and 6 mL/s.Each group(20 cases) was again divided into to two groups according to ROI(200 HU and 350 HU),scannings were started after reaching an ROI threshold at 4 s later.A total of2 mL/kg of body weight of contrast material containing 350 mg of iodine per milliter was injected through 18-gauge plastic intravenous catheters which were placed at antecubital vein.Image data were transferred to a workstation.Volume reformation,multiplanar reformation,maximum intensity projection and curved multiplanar reformation images were analysed by two radiologists independently.The AKAs were identified as an enhanced vessel oriented toward the anterior cord and joining the anterior spinal artery at the tip of a topical hairpin sign.Results The AKAs were identified in 7,6,11,10,19 and 18 patients in 4 mL/s,200 HU and 350 HU groups,5 mL/s,200 HU and 350 HU groups,6 mL/s,200 HU and 350 HU groups,respectively,there were statistically significant differences(P<0.01) between them.Conclusion At an injection rate of 6 mL/s,after reaching an ROI threshold of 200 HU or350 HU,256-detector CT angiography can depict Adamkiewicz artery accurately.更多还原